HIV-positive Breastfeeding Women Research Articles

Determinants of option B+ HIV treatment adherence among HIV-positive breastfeeding women in Zimbabwe.

Zimbabwe is one of the countries in sub-Saharan Africa with the highest prevalence of HIV. Despite the launch of the Option B+ treatment approach in 2013 to eliminate mother-to-child transmission, the number of pregnant women and children living with HIV is still high due to non-adherence. This prompted this study with the aim to explore the determinants of adherence to Option B+ HIV treatment among HIV-positive breastfeeding women. This descriptive phenomenological study explored the lived experiences of 12 purposively recruited HIV-positive breastfeeding women in 2020 through in-depth interviews. The collected data were analysed using Colaizzi's phenomenological data analysis framework. The study findings revealed that client-related factors such as food insecurity, travel, early infant diagnosis, and treatment-related factors such as the unavailability of drugs, the side effects of medications, and health institution-related factors are barriers to adherence among HIV-positive breastfeeding women. The findings also indicated that support from the family, health care workers, awareness of the benefits of the treatment plan, and positive role models are promoters of adherence. To improve breastfeeding women's adherence to Option B+ HIV treatment, the identified barriers to adherence should be addressed while optimising the motivators of adherence.

Evaluation of strategies for the prevention of mother-to-child transmission of HIV in Cameroon: a mixed qualitative and quantitative cross-sectional analysis from the Adamawa region of Cameroon

BackgroundTo accelerate the fight against HIV/AIDS and eliminate the mother-to-child transmission (MTCT) of the virus, Cameroon has implemented and intensified several strategies despite which numerous children continue to be born infected with HIV. This study aimed to evaluate these strategies put in place for the prevention of MTCT (PMTCT) in Cameroon.MethodsA qualitative and quantitative cross-sectional analysis was conducted in seven PMTCT care units situated in the Adamawa region of the country. The qualitative analysis included 16 individual interviews of key informants and observations of attitudes and practices being implemented in each unit. On the other hand, the quantitative analysis targeted 106 known HIV-positive breastfeeding women being followed-up at the unit.ResultsTask-shifting and sharing was effective, but majority of staffs had not received any specific training on PMTCT. Moreover, the integration of PMTCT within the maternal, neonatal and child health services remained ineffective, especially in health facilities of heavy workload. The coordination of PMTCT services was led by a well-designated focal person; however, his/her roles and responsibilities had not clearly been defined. Of the 106 women enrolled, 59.4% had a level of knowledge on PMTCT less than 80%. Similarly, their attitudes and practices towards PMTCT were inadequate or inaccurate in more than 60% of cases.ConclusionPMTCT strategies are globally well known and accepted by healthcare professionals. However, weaknesses have been figured out regarding service integration, task shifting and sharing, and coordination. In addition, beneficiaries’ attitudes and practices are insufficient, and their level of knowledge does not guarantee to lessen the risk of MTCT of HIV.

The experiences of HIV-positive mothers breastfeeding exclusively in Swaziland

In Swaziland, 41.1% of pregnant women live with HIV, while only 32% of Swazi mothers (including HIV negative mothers) currently practice exclusive breastfeeding among infants less than six months of age. The rate of exclusive breastfeeding decreases with an increase in the infant’s age, as only 17% of infants aged four to five months are reported to be exclusively breastfed. Exclusive breastfeeding is recommended by the ministry of health of Swaziland to reduce postnatal HIV transmission of HIV to the infant, through the prevention of mother-to-child transmission of HIV (PMTCT) strategy. However, little is known about HIV-positive mothers’ perspectives and experiences of exclusive breastfeeding in Swaziland. Therefore, a hospital-based explorative, descriptive qualitative study design was employed to describe the experiences of HIV-positive mothers in Swaziland breastfeeding exclusively. Seven exclusive breastfeeding, HIV-positive mothers, aged 21-41 years, married and unemployed, participated during two visits to the study site. Responses to semi-structured and in-depth interviews, through purposive sampling, were analyzed in order to generate themes. Five major themes emerged: (i) benefits of breast milk to the mother and the baby; (ii) social support factors; (iii) the role of healthcare workers in promoting exclusive breastfeeding; (iv) psychological relief from a baby’s negative test result; and (v) challenges faced by breastfeeding mothers. Despite pressure from relatives and in-laws for some of the participants, they continued to breastfeed exclusively for the first six months of the baby’s life, stating that breastfeeding benefited themselves and their infants. Continuous teaching and counseling offered by nurses during child-welfare clinic visits motivated the mothers to continue breastfeeding exclusively. In view of the challenges expressed by mothers, there is a need to develop and implement feasible interventions to improve support for HIV-positive mothers, in order to scale up exclusive breastfeeding practices in the country. Counseling on exclusive breastfeeding should also include the in-laws as they play a pivotal role in child feeding. This study contributes to the body of knowledge on infant feeding and provides insights to healthcare professionals and stakeholders working with HIV-positive breastfeeding women.

Deficiencies of macronutrient intake among HIV-positive breastfeeding women in Dar es Salaam, Tanzania.

We compared macronutrient intake, food insecurity, and anthropometrics in breastfeeding women: 40 HIV-positive women not yet on antiretroviral therapy and 40 HIV-negative women. Calculated deficits at 2 weeks were 517 kcal per day for HIV-positive women vs 87 kcal per day surplus for HIV-negative women (P = 0.01) and 29 g protein per day for HIV-positive women vs 16 g protein per day for HIV-negative women (P = 0.04). Food insecurity scores were 11.3 for HIV-positive women vs 7.8 for HIV-negative women (P < 0.01). Enhanced dietary education together with macronutrient supplementation may be required to improve health outcomes in HIV-positive women and their infants.

Perceptions of the Role of Maternal Nutrition in HIV-Positive Breast-Feeding Women in Malawi ,

A neglected issue in the literature on maternal nutrition and HIV is how HIV-positive women perceive their own bodies, health, and well-being, particularly in light of their infection, and whether these perceptions influence their infant feeding practices and their perceived ability to breast-feed exclusively through 6 mo. We conducted formative research to better understand breast-feeding practices and perceptions, and to inform the Breastfeeding, Antiretroviral, and Nutrition (BAN) Study, a clinical trial to evaluate antiretroviral and nutrition interventions to reduce mother-to-child transmission of HIV during breast-feeding in Lilongwe, Malawi. Twenty-two HIV-positive women living in semi-rural areas on the periphery of Lilongwe participated in in-depth interviews. In an adaptation of the body-silhouette methodology, nine culturally appropriate body silhouettes, representing a continuum of very thin to very large shapes, were used to elicit women's views on their present, previous-year, and preferred body shapes, and on the shape they perceived as healthy. The narrative scenario method was also used to explore women's views on 2 fictional women infected with HIV and their ability to exclusively breast-feed. Women perceived larger body shapes as healthy, because fatness is considered a sign of good health and absence of disease, and many recognized the role of nutrition in achieving a preferred or healthy body shape. Several women believed their nutritional status (body size) was declining because of their illness. Women were concerned that breast-feeding may increase the progression of HIV, suggesting that international guidelines to promote appropriate infant feeding practices for infants whose mothers are infected with HIV should focus on the mother's health and well-being, as well as the infant's.