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Abstract
DETERMINANTS OF HIV POSITIVE WOMEN'S INFANT FEEDING CHOICES: AN ETHNOGRAPHIC STUDY IN RURAL KWA/ZULU NATAL
L. Thairu1, G.H. Pelto1, N.C. Rollins2, R.M. Bland2
1Cornell University, Ithaca, New York, USA, 2Africa Center for Health and Population Studies, Mtubatuba, South Africa
Purpose: The promotion of exclusive breastfeeding, followed by rapid transition to alternative food sources, is an important public health approach to the reduction of mother-to-child transmission of HIV through breastmilk, particularly in conditions in which formula feeding presents significant risks for infant health. The basic principle of “informed choice” requires that HIV+ women are provided with adequate information about their options. However, information is only one factor that determines their decisions. The objective of this ethnographic study was to investigate socio-cultural influences on infant feeding decisions in rural Kwa/Zulu Natal.
Methods: 22 HIV positive women were purposively selected from a larger cohort study designed to reduce mother-to-child transmission by improving infant feeding practices in KwaZulu Natal (South Africa). Participant observation and in-depth interviews were used to elicit their views on infant feeding and health. Interviews were conducted in Zulu and were tape-recorded, transcribed and analyzed with the aid of a software program (NUD-ist 6.)
Results: Several themes concerning influences on decisions emerged, including level of fear about HIV, concern about social stigma, as well as the importance of women’s age, family structure, and level of economic independence. For example, among the 5 women who chose formula (a choice made by a small fraction in the full study), 4 spontaneously described their fear of the disease and transmitting it to their infant as the basis for their choice. Some of the women who selected breastfeeding expressed the view that choosing to use formula was tantamount to announcing their HIV positive status and feared social stigma as a consequence.
Conclusions: Identifying the issues that influence decision-making as viewed by the women who must make difficult choices under difficult circumstances may facilitate the development of programs and policies that address these concerns, and thus provide improved support for informed choice and adherence to that choice once a decision has been made.
The 2nd IAS Conference on HIV Pathogenesis and Treatment
Abstract no.
1054
Suggested Citation
" L. Thairu , et al.
DETERMINANTS OF HIV POSITIVE WOMEN'S INFANT FEEDING CHOICES: AN ETHNOGRAPHIC STUDY IN RURAL KWA/ZULU NATAL.
Poster:
The 2nd IAS Conference on HIV Pathogenesis and Treatment:
Abstract no.
1054"
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