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The challenges of adherence to infant feeding choices in prevention of mother-to-child transmission of HIV infections in South East Nigeria

Authors Lawani LO, Onyebuchi AK, Iyoke CA, Onoh RC, Nkwo PO

Received 3 February 2014

Accepted for publication 4 March 2014

Published 26 March 2014 Volume 2014:8 Pages 377—381

DOI https://doi.org/10.2147/PPA.S61796

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Lucky O Lawani,1 Azubuike K Onyebuchi,2 Chukwuemeka A Iyoke,3 Robinson C Onoh,2 Peter O Nkwo3

1
School of Postgraduate Studies, Department of Community Medicine, University of Nigeria, Enugu Campus, Enugu State, Nigeria; 2Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria; 3Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Enugu, Enugu State, Nigeria

Background: Global and national efforts in the 21st century are directed toward the elimination of new pediatric HIV infections through evidence-based infant feeding interventions for the prevention of mother-to-child-transmission, with patient preference, motivation, and adherence identified as key factors for success.
Objectives: This study assessed the challenges faced by HIV-infected parturients in adhering to the national infant feeding recommendations and their infant feeding preference for prevention of mother-to-child transmission in South East Nigeria.
Methods: This is a cross-sectional, descriptive, questionnaire-based study of 556 parturients infected with HIV/AIDS.
Results: The mean age of the participants was 28.0±5.3 years. The infant feeding choices were made jointly by both partners (61.1%) in the antepartum period. The HIV status disclosure rate was 89.2%. A large proportion (91.7%) practiced exclusive breastfeeding with highly active antiretroviral therapy, and 7.6% practiced mixed feeding because of nonadherence to their choice and national/international recommendations on infant feeding in the context of HIV/AIDS. This was mainly a result of pressure from family members (42.8%) and cultural practices (28.5%). Multivariate logistic regression analysis indicates that adherence was strongly associated with age, marital status, and employment status, but not with residence, educational status, or parity.
Conclusion: Exclusive breastfeeding is predominately the infant feeding choice among HIV-infected parturients in South East Nigeria, but there is still a gap between infant feeding preference and adherence to standard practice as a result of sociocultural challenges associated with risk for mixed feeding and the risk for mother-to-child-transmission of HIV by nursing mothers.

Keywords: PMTCT, HIV, infant feeding, challenges, HAART, adherence

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