Influences on exclusive breastfeeding among rural HIV-infected South African women: a cluster randomized control trial

SOURCE: AIDS and Behavior
OUTPUT TYPE: Journal Article
PUBLICATION YEAR: 2018
TITLE AUTHOR(S): D.L.Jones, V.J.Rodriquez, L.N.Mandell, T.K.Lee, S.M.Weiss, K.Peltzer
KEYWORDS: BREASTFEEDING, HIV/AIDS, PREVENTION OF MOTHER TO CHILD TRANSMISSION (PMTCT) PROGRAMME, RURAL COMMUNITIES, WOMEN
DEPARTMENT: Social Aspects of Public Health (SAPH)
Print: HSRC Library: shelf number 10450

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Abstract

South African guidelines for prevention-of-mother-to-child-transmission (PMTCT) of HIV emphasize exclusive breastfeeding (EBF). This study examined the impact of a PMTCT intervention and male involvement on EBF. In a two-phase cluster randomized trial, rural South African community health centers were randomized to offer HIV-infected pregnant women PMTCT standard of care plus either: a behavioral PMTCT intervention, or a time-equivalent attention-control condition. Phase 1 women had non-participating male partners; Phase 2 women had participating partners. Pregnant women (n = 1398) were assessed on HIV stigma, disclosure of HIV status to partner, male involvement, and family planning knowledge. Feeding practices were assessed 6 weeks postpartum (56% retained). Reduced depressive symptomatology predicted EBF 6 weeks postpartum, adjusting for attrition (AOR = 0.954, p = 0.001). Neither male involvement in antenatal care, phase, HIV stigma, disclosure, nor family planning knowledge predicted EBF. Future studies and perinatal care should address depression, which has important implications for infant health.