The infant feeding practices of Human Immunodeficiency Virus positive women within the Prevention of Mother to Child Transmission program in Soweto, Johannesburg

[摘要] Introduction: In South Africa, over 25% of all babies born each year are exposed toHIV. The high antenatal HIV sero-prevalence rates coupled with high levels of maternalmorbidity and mortality advocate for high quality maternal and child health care, whichshould include resilient PMTCT programs. This study aimed to explore infant feedingpractices selected by HIV-positive women enrolled on a PMTCT program and describesome of the reasons for their choices, within the first 6 months postpartum. The studyalso reports on infant feeding practice and HIV status of the infant.Methodology: The study was a cross-sectional study which was carried out within thePerinatal Research Unit at Chris Hani Baragwanath hospital in Soweto. A sample of 200women enrolled in the PMTCT program was interviewed, using a semi-structuredquestionnaire, during April 2007 – June 2007.Results: The study revealed that 84.5% of the study population had received infantfeeding counseling. There was a high rate of exclusive formula feeding (EFF=84.5%),with lower exclusive breastfeeding (EBF=14%) and mixed feeding (MF=1.5%) rates.The corresponding HIV transmission rates were EFF – 26% (n=44/169); EBF – 75%(n=21/28); MF – 100% (n=3/3). The study demonstrated that babies born to mothers whodid not receive information on infant feeding were twice as likely to be HIV positive(OR=2.43), which was statistically significant. The study also showed that the timing ofthe counseling was critical – all mothers who received counseling 6 weeks or more afterdelivery had HIV-positive babies. The overwhelming majority of women (78%) indicatedthat they would breast feed their babies if they were HIV-negative.Conclusion: The study demonstrated the vital role of infant feeding counseling inantenatal care and PMTCT programs. It illustrated that it was critically important that allHIV-infected women receive infant feeding counseling as soon as possible after the HIVdiagnosis is made, prior to delivery and highlighted the importance of reinforcement ofinfant feeding choice at every antenatal care visit, for every woman.5The key recommendations focus on the need for:• Improved Antenatal care for all pregnant women• Improved care for HIV-positive pregnant women• Improvements in infant feeding counseling for HIV positive women• Integration of Maternal, Child health and PMTCT programs• Intensification of ongoing prevention efforts• The need for further research to:o identify some of the reasons HIV positive women choose certain infantfeeding modalities throughout the country, and the challenges associatedwith these; ando critically evaluate the training that health care workers and counselorsreceive, regarding infant feeding counseling.

[发布机构] University of the Witwatersrand