Dilemma for Choosing Exclusive Replacement Feeding for HIV Positive Mothers of Infants at a Public Hospital in Gauteng Province, South Africa

Abstract

The burden of the Acquired Immune Deficiency Syndrome (AIDS) epidemic is greatest in poor resource settings. In particular 22.5 million of the 33.2 million individuals infected with HIV globally live in Sub-Saharan Africa (SSA). South Africa as well is having a large number of mothers with this burden of HIV infection. Infant feeding in communities with a high prevalence of HIV/AIDS has a potential challenge for mothers who must ultimately decide how to feed their infants within the context that constrain their choices. The purpose of this study was to determine challenges of HIV-positive mothers on exclusive replacement feeding. A qualitative, exploratory, descriptive and contextual study was undertaken to examine the experiences of HIV positive mothers on the exclusive formula feeding. Fifteen interviews women agreed to participate but only 12 women were interviewed using semi-structured interviews based on data saturation. Interviews were transcribed verbatim and analysed by means of content analysis and coding. Five themes emerged from this study, namely: Mothers knowledge of recommended feeding practices; fear of disclosure due to stigma; limited support; social isolation and mother’s strategies. The shame associated with HIV is a major obstacle to its prevention, and the stigma that surrounds people is compounded by discrimination against women, leading to women avoiding testing and treatment services for fear of abandonment and other repercussions from husbands, families, and communities and health providers.

Keywords: Exclusive Replacement Feeding, Infant Feeding, Prevention of Mother-to-Child Transmission, Choice, Human Deficiency Virus, Epidemic