Introduction: In Uganda, Human Immunodeficiency Virus (HIV) was first reported at Kasensero landing site in Rakai district, in the South Western region in 1982. The district has continued to experience high HIV rates at 12% compared to the national average of 7.3% with relatively higher vertical transmission rates. Objective: The purpose of this study was to determine the individual determinants of adherence to feeding guidelines for infants born to HIV positive mothers in Rakai District, Uganda. Methodology: A descriptive cross-sectional study design was used with a sample size of 138 respondents and employing quantitative method of enquiry. A non-probability sampling strategy called consecutive sampling was used to sample the mothers with HIV. Data were analyzed using SPSS to generate descriptive and bivariate analysis data. Results: Individual determinants found to have a statistically significant influence to feeding guidelines for infants born to mothers living with HIV were: Age (X2 = 45.967, P-value = 0.000), Number of children (X2 = 93.069, P-value = 0.000), Number of children given birth to since diagnosis (X2 = 18.604, P-value = 0.000), income per month (X2 = 50.477, P-value = 0.000), ever had breast complication (X2 = 15.039, P-value = 0.000), disclosure of HIV status (X2 = 10.740, P-value = 0.001), quantity of breast milk produced (X2 = 10.637, P-value = 0.0005) and whether mothers attended antenatal care services (X2 = 38.613, P-value = 0.000). Conclusion: Age, Number of Children, Number of Children given birth to since diagnosis, breast complications, disclosure of HIV status, quantity of breast milk produced and utilization of antenatal care services were found to have an association with the adherence to feeding guidelines among HIV positive mother and this was statistically significant. Recommendation: General improvement of socio-economic status of the mothers should be done and be given priority so that in turn it will enable the women to adequately focus on maintaining optimum and the health of their children.
References
[1]
Ministry of Health (2017) Uganda AIDS Indicator Survey. Ministry of Health, Kampala. https://dhsprogram.com/pubs/pdf/AIS10/AIS10.pdf
[2]
Onubogu, C.U., Ugochukwu, E.F., Egbuonu, I., Azikiwe, N., Onyeka, I.N. and Onubogu, C. (2012) Adherence to Infant-Feeding Choices by HIV-Infected Mothers at a Nigerian Tertiary Hospital: The Pre-“Rapid Advice” Experience. South African Journal of Clinical Nutrition, 28, 180-186.
https://doi.org/10.1080/16070658.2015.11734558
[3]
Desclaux, A. and Alfieri, C. (2009). Counseling and Choosing between Infant-Feeding Options: Overall Limits and Local Interpretations by Health Care Providers and Women Living with HIV in Resource-Poor Countries (Burkina Faso, Cambodia, Cameroon). Social Science & Medicine, 69, 821-829.
https://doi.org/10.1016/j.socscimed.2009.06.007
[4]
Doherty, T., Chopra, M., Nkonki, L., Jackson, D. and Greiner, T. (2006). Effect of the HIV Epidemic on Infant Feeding in South Africa: When They See Me Coming with the Tins They Laugh at Me. Bulletin of the World Health Organization, 84, 90-96. https://doi.org/10.2471/BLT.04.019448
[5]
Mataya, R., Mathanga, D., Chinkhumba, J., Chibwana, A., Chikaphupha, K. and Cardiello, J. (2013) A Qualitative Study Exploring Attitudes and Perceptions of HIV Positive Women Who Stopped Breastfeeding at Six Months to Prevent Transmission of HIV to Their Children. Malawi Medical Journal, 25, 15-19.
[6]
Hofmann, J., De Allegri, M., Sarker, M., Sanon, M. and Bohler, T. (2009). Breast Milk as the “Water that Supports and Preserves Life”—Socio-Cultural Constructions of Breastfeeding and Their Implications for the Elimination of Mother to Child Transmission of HIV in Sub-Saharan Africa. Health Policy, 89, 322-328.
https://doi.org/10.1016/j.healthpol.2008.06.005
[7]
Fadnes, L.T., Engebretsen, I.M., Wamani, H., Wangisi, J., Tumwine, J.K. and Tylleskar, T. (2009). Need to Optimise Infant Feeding Counselling: A Cross-Sectional Survey among HIV-Positive Mothers in Eastern Uganda. BMC Pediatrics, 9, 2.
https://doi.org/10.1186/1471-2431-9-2
[8]
Ostergaard, L.R. and Bula, A. (2010) “They Call Our Children, Nevirapine Babies”: A Qualitative Study about Exclusive Breastfeeding among HIV Positive Mothers in Malawi. African Journal of Reproductive Health, 14, 213-222.
[9]
Thairu, L.N., Pelto, G.H., Rollins, N.C., Bland, R.M. and Ntshangase, N. (2005) Sociocultural Influences on Infant Feeding Decisions among HIV-Infected Women in Rural Kwa-Zulu Natal, South Africa. Maternal & Child Nutrition, 1, 2-10.
https://doi.org/10.1111/j.1740-8709.2004.00001.x
[10]
Buskens, I., Jaffe, A. and Mkhatshwa, H. (2007). Infant Feeding Practices: Realities and Mindsets of Mothers in Southern Africa. AIDS Care, 19, 1101-1109.
https://doi.org/10.1080/09540120701336400
[11]
Marembo, J., Zvinavashe, M., Nyamakura, R., Shaibu, S. and Mogobe, K.D. (2014) Factors Influencing Infant-Feeding Choices Selected by HIV-Infected Mothers: Perspectives from Zimbabwe. Japan Journal of Nursing Science, 11, 259-267.
https://doi.org/10.1111/jjns.12027
[12]
Onono, M.A., Cohen, C.R., Jerop, M., Bukusi, E.A. and Turan, J.M. (2014) HIV Serostatus and Disclosure: Implications for Infant Feeding Practice in Rural South Nyanza, Kenya. BMC Public Health, 14, 390.
https://doi.org/10.1186/1471-2458-14-390
[13]
Kimani-Murage, E.W., Madise, N.J., Fotso, J.C., Kyobutungi, C., Mutua, M.K., Gitau, T.M. and Yatich, N. (2011) Patterns and Determinants of Breastfeeding and Complementary Feeding Practices in Urban Informal Settlements, Nairobi Kenya. BMC Public Health, 11, 396. https://doi.org/10.1186/1471-2458-11-396
[14]
Webb-Girard, A., Cherobon, A., Mbugua, S., Kamau-Mbuthia, E., Amin, A. and Sellen, D.W. (2012) Food Insecurity Is Associated with Attitudes towards Exclusive Breastfeeding among Women in Urban Kenya. Maternal & Child Nutrition, 8, 199-214. https://doi.org/10.1111/j.1740-8709.2010.00272.x
[15]
Kafulafula, U.K., Hutchinson, M.K., Gennaro, S., Guttmacher, S. and Kumitawa, A. (2013) Exclusive Breastfeeding Prenatal Intentions among HIV-Positive Mothers in Blantyre, Malawi: A Correlation Study. BMC Pregnancy and Childbirth, 13, 203.
https://doi.org/10.1186/1471-2393-13-203
[16]
Abiona, T.C., Onayade, A.A., Ijadunola, K.T., Obiajunwa, P.O., Aina, O.I. and Thairu, L.N. (2006). Acceptability, Feasibility and Affordability of Infant Feeding options for HIV-Infected Women: A Qualitative Study in South-West Nigeria. Maternal & Child Nutrition, 2, 135-144.
https://doi.org/10.1111/j.1740-8709.2006.00050.x
[17]
Wachira, J., Otieno-Nyunya, B., Ballidawa, J. and Braitstein, P. (2009). Assessment of Knowledge, Attitudes and Practices of Infant Feeding in the Context of HIV: A Case Study from Western Kenya. SAHARA-J: Journal of Social Aspects of HIV/AIDS, 6, 120-133. https://doi.org/10.1080/17290376.2009.9724940
[18]
Madiba, S. and Letsoalo, R. (2013). HIV Disclosure to Partners and Family among Women Enrolled in Prevention of Mother to Child Transmission of HIV Program: Implications for Infant Feeding in Poor Resourced Communities in South Africa. Global Journal of Health Science, 5, 1. https://doi.org/10.5539/gjhs.v5n4p1
[19]
Koricho, A.T., Moland, K.M. and Blystad, A. (2010). Poisonous Milk and Sinful Mothers: The Changing Meaning of Breastfeeding in the Wake of the HIV Epidemic in Addis Ababa, Ethiopia. International Breastfeeding Journal, 5, 12.
https://doi.org/10.1186/1746-4358-5-12
[20]
Chisenga, M., Siame, J., Baisley, K., Kasonka, L. and Filteau, S. (2011). Determinants of Infant Feeding Choices by Zambian Mothers: A Mixed Quantitative and Qualitative Study. Maternal & Child Nutrition, 7, 148-159.
https://doi.org/10.1111/j.1740-8709.2010.00264.x
[21]
Setia, M.S. (2016) Methodology Series Module 3: Cross-Sectional Studies. Indian Journal of Dermatology, 61, 261-264. https://doi.org/10.4103/0019-5154.182410
[22]
Uganda Bureau of Statistics (2009) Rakai District Statistical. Abstract.
[23]
Kunihira, N.R., Nuwaha, F., Mayanja, R. and Peterson, S. (2010). Barriers to Use of Antiretroviral Drugs in Rakai District of Uganda. African Health Sciences, 10, 120-129.
[24]
Kish, L. (1965). Survey Sampling No. 04 HN29, K5.
[25]
Harvey, N.C., Robinson, S.M., Crozier, S.R., Marriott, L.D., et al. (2009) Breast-Feeding and Adherence to Infant Feeding Guidelines Do Not Influence Bone Mass at Age 4 Years. British Journal of Nutrition, 102, 915-920.
https://doi.org/10.1017/S0007114509317420
[26]
Doherty, T., Chopra, M., Jackson, D., Goga, A., Colvin, M. and Persson, L.A. (2007). The Effectiveness of the WHO/UNICEF Guidelines on Infant Feeding for HIV-Positive Women: Results from a Prospective Cohort Study in South Africa. AIDS, 21, 1791-1797. https://doi.org/10.1097/QAD.0b013e32827b1462
