Abstract
BackgroundMother-to-child transmission (MTCT) of Human immunodeficiency virus (HIV) through breastfeeding remains the most significant route infection among children. Although the current guideline is recommending continued breastfeeding for HIV exposed infants, significant proportion of infants have been subjected to early weaning to prevent HIV transmission. However the predictors of breastfeeding cessation among HIV positive mothers were not documented in Ethiopia. Therefore the objective of this study was to determine the predictors of breastfeeding cessation among HIV-infected women in Southern Ethiopia.MethodsA facility based cross sectional study was conducted in Southern Ethiopia. The samples were selected by cluster sampling technique. The Kaplan-Meier curve was used to describe the survival time of breastfeeding and a step-wise multivariable Cox-proportional hazards regression model were used to identify the predictors of breastfeeding cessation. Both crude and adjusted hazard ratio were determined and p<0.05 was considered as statistically significant.ResultThe mean duration of breastfeeding among HIV positive mothers was 13.79 [95% CI: (12.97–14.59)] months. The Kaplan-Meier estimate showed that proportions of women who were breastfeeding at 6, 9, 12 and 17 months were 89.3%, 75.3%, 66% and 17%, respectively. Those mothers having a monthly income of ≤500 ETB [AHR = 0.16, 95% CI :(0.03–0.76)], having a family size of three and below [AHR = 0.12, 95%CI: (0.02–0.68), four and above [AHR = 0.07, 95%CI: (0.01–0.35)] and bottle feeding [AHR = 3.95, 95%CI: (1.64–9.51)] were also independent factors associated with breastfeeding cessation.ConclusionAbove one third of HIV positive mothers stopped breastfeeding before 12 months. Monthly income, bottle feeding and family size were the independent predictors of breastfeeding cessations. Strengthening the current counseling and promotion modality on avoidance of bottle feeding and continued breastfeeding is recommended for improved HIV free survival.
Highlights
Mother-to-child transmission (MTCT) of Human immunodeficiency virus (HIV) has remained the most significant route of HIV infection among children [1]
Above one third of HIV positive mothers stopped breastfeeding before 12 months
Bottle feeding and family size were the independent predictors of breastfeeding cessations
Summary
Mother-to-child transmission (MTCT) of HIV has remained the most significant route of HIV infection among children [1]. Multiple studies in low-income countries have documented increased morbidity and mortality associated with early cessation of breastfeeding compared to continued breastfeeding among HIV exposed children. Cessation of breastfeeding to prevent HIV transmission would increase the risk of severe morbidities and mortality associated among HIV exposed infants who were weaned early (at 4–6 months of age), compared with those who breastfed (BF) for longer periods [5,6,7,8]. A study from Zambia revealed that breastfeeding cessation is associated with malnutrition which showed a significant decrease in weight-for-age Z-scores among HIV exposed infants who stopped breastfeeding early (at 4 months) compared to those who breastfed continuously [9].
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