Abstract:
Guidelines for infant feeding options among HIV-positive mothers are changing with informative research. Cultural factors,
socialisation processes, gender dimensions and socio-economic status within communities should be considered in recommending
feasible and sustainable options. The objective of this study was to assess the knowledge, attitudes and practices with regards to
infant feeding in the context of HIV. A cross-sectional study was conducted between November 2003 and January 2004. The study
was carried out in Kosirai Division, Nandi-North District, in western Kenya. The target population was community members aged
18 - 45 years and key informants aged 18 years and above. Structured questionnaires and in-depth interviews were used to collect
data. Multistage and snowball sampling methods were used to identify study participants. Quantitative data were analysed using
the SPSS statistical package for social scientists (Version 12). Cross-tabulations were calculated and Pearson’s chi-square test used to
test significance of relationships between categorical variables. Recorded qualitative data were transcribed and coded. Themes were
developed and integrated. A generation of concepts was used to organise the presentation into summaries, interpretations and text.
A total of 385 individuals participated in the survey, 50% of whom were women. There were 30 key informants. Farming was the
main source of income but half of the women (49.7%) had no income. Most of the respondents (85.5%) knew of breastfeeding as
a route of HIV transmission with sex (p=0.003) and age (p=0.000) being highly associated with this knowledge. Breastfeeding was
the norm although exclusive breastfeeding was not practised. Cow’s milk, the main breast milk substitute, was reported as being
given to infants as early as two weeks. It was the most popular (93.5%) infant feeding option in the context of HIV/AIDS. Heating
expressed milk, wet nursing and milk banks were least preferred. Thus, the social, cultural and psychological complexity of infant
feeding practices should be taken into account when advocating appropriate infant feeding options. Further research is required to
determine the safety of using cow’s milk as an infant feeding option. Community engagement, including education and awareness
strategies, specific to the benefits of exclusive breastfeeding as a mechanism to reduce the risk of HIV transmission is urgently
needed.
