Psychosocial and economic determinants of infant feeding intent by pregnant HIV-infected women in Tshwane / Pretoria

Objectives. To determine the extent to which stigma, disclosure, coping and socio-economic factors would affect infant feeding choices made antenatally by pregnant HIV-positive women after the routine prevention of mother-to-child transmission counselling process. Patients and methods. The antenatal feeding choices and determinants of these choices of HIV-infected women were studied at four antenatal clinics in two Tshwane townships, between June 2003 and December 2005. Results. Seventy-four per cent of the 293 study participants intended to formula feed their babies, while 26% planned to breastfeed or mixed feed. The women who intended to breastfeed had lower active coping ability (adjusted odds ratio (AOR) 0.88, 95% confidence interval (CI) 0.82 - 0.94), were less likely to have disclosed their status to partners or husbands (AOR 0.54, 95% CI 0.30 - 0.99), were twice as likely to be married (AOR 2.06, 95% CI 1.03 - 4.12) and were twice as knowledgeable about HIV transmission through breastfeeding (AOR 2.11, 95% CI 1.14 - 3.90). Conclusion. Counselling on infant feeding choices among HIV-infected women should be sensitive to the numerous internal and external factors that influence the decision. The support that HIV-infected women need in making their infant feeding decisions will entail psychosocial, community-wide interventions, and frequent counselling sessions to assist them in coping with and disclosing their status.