Dataset Information

Infant Feeding Practices of HIV Positive Mothers and Its Association with Counseling and HIV Disclosure Status in Ethiopia: A Systematic Review and Meta-Analysis.

ABSTRACT:

Introduction

Breastfeeding is the ideal food source for all newborns globally. However, in the era of Human Immune Deficiency Virus (HIV) infection, feeding practice is a challenge due to mother-to-child HIV transmission. Therefore, this systematic review and meta-analysis aimed to estimate the national prevalence of exclusive breastfeeding and mixed feeding practices among HIV positive mothers and its association with counseling and HIV disclosure status to the spouse in Ethiopia.

Methods

We searched all available articles from the electronic databases including PubMed, EMBASE, Google Scholar, and the Web of Science. Moreover, reference lists of the included studies and the Ethiopian institutional research repositories were used. Searching of articles was limited to the studies conducted in Ethiopia and published in English language. We have included observational studies including cohort, cross-sectional, and case-control studies. The weighted inverse variance random effects model was used. The overall variations between studies were checked through heterogeneity test (I²). Subgroup analysis by region was conducted. To assess the quality of the study, the Joanna Briggs Institute (JBI) quality appraisal criteria were employed. Publication bias was checked with the funnel plot and Egger's regression test.

Result

A total of 18 studies with 4,844 participants were included in this study. The national pooled prevalence of exclusive breastfeeding and mixed feeding practices among HIV positive mothers were 63.43% (95% CI: 48.19, 78.68) and 23.11% (95% CI: 10.10, 36.13), respectively. In the subgroup analysis, the highest prevalence of exclusive breastfeeding practice was observed in Tigray (90.12%) and the lowest in Addis Ababa (41.92%). Counseling on feeding option with an odds ratio of 4.32 (95% CI: 2.75, 6.77) and HIV disclosure status to the spouse with an odds ratio of 6.05 (95% CI: 3.03, 12.06) were significantly associated with exclusive breast feedings practices.

Conclusion

Most mothers report exclusive breastfeeding, but there are still almost a quarter of mothers who mix feed. Counseling on feeding options and HIV disclosure status to the spouse should be improved.

SUBMITTER: Belay GM

PROVIDER: S-EPMC6699255 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Publications

Infant Feeding Practices of HIV Positive Mothers and Its Association with Counseling and HIV Disclosure Status in Ethiopia: A Systematic Review and Meta-Analysis.

Belay Getaneh Mulualem GM Wubneh Chalachew Adugna CA

AIDS research and treatment 20190801

<h4>Introduction</h4>Breastfeeding is the ideal food source for all newborns globally. However, in the era of Human Immune Deficiency Virus (HIV) infection, feeding practice is a challenge due to mother-to-child HIV transmission. Therefore, this systematic review and meta-analysis aimed to estimate the national prevalence of exclusive breastfeeding and mixed feeding practices among HIV positive mothers and its association with counseling and HIV disclosure status to the spouse in Ethiopia.<h4>Me ...[more]

PMID: 31467708

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Project description:IntroductionDisclosure of HIV status to sexual partners can help HIV prevention efforts and enable HIV positive people to receive social support, as well as increasing access and adherence to treatment. This study was conducted to determine the rate, processes, outcomes, and correlates of HIV status disclosure to sexual partners among HIV positive individuals.MethodA cross-sectional study was conducted between September and November 2015 at two HIV outpatient clinics in Addis Ababa, Ethiopia. Data were collected using an interviewer- administered semi-structured questionnaire. Logistic analysis was used to determine the independent correlates of serostatus disclosure.ResultsOf 742 participants, (371 men and 371 women), 727 (98%) were on antiretroviral therapy and 676 (91.1%) had at least one sexual partner since their HIV diagnosis, of whom 558 (82.5%) had disclosed their HIV status to their most recent sexual partner. Of those who reported having disclosed their status to their most recent sexual partner, 82 (14.7%) had at least one unprotected sexual encounter with the partner, after HIV diagnosis but prior to disclosure. The most commonly reported initial outcome of disclosure was gaining emotional and/or financial support. Some (11.3%) also reported that their disclosure immediately initiated their partner for HIV testing. Negative outcomes to disclosure, such as stigma and discrimination, were more common among females (26.2%) compared to males (12.7%). In the multiple regression analysis, disclosure was associated with greater condom use, greater social support, knowing the partner's HIV status, having a good relationship with the partner, and cohabiting with the partner.ConclusionHIV disclosure was common amongst participants, although sometimes delayed, with possible consequences for onward transmission. Fear of negative outcomes, such as verbal abuse and physical violence, were major barriers to disclosure. Efforts to support disclosure have the potential to contribute to HIV control and prevention by encouraging safer sexual practice, initiating partners for HIV testing, and enhancing support for people living with HIV.

Project description:Introduction HIV-positive status disclosure for children is challenging for family members, guardians, and healthcare professionals. Disclosure is very challenging, particularly for children, yet no systematic synthesis of evidence accurately measures HIV-positive status disclosure in children. This systematic review and meta-analysis study aimed to quantify the national prevalence of pediatric HIV-positive status disclosure in Ethiopia and identify factors associated with HIV-positive status disclosure. Method We systematically searched PubMed, EMBASE, Web of Science databases, and google scholar for relevant published studies. Studies published in the English language and conducted with cohort, case-control, and cross-sectional designs were eligible for the review. The primary and secondary outcomes of the study were HIV-positive status disclosure and factors associated with HIV-positive status disclosure, respectively. The quality of the included studies was assessed using the Joanna Briggs Institute critical appraisal tools. A random effect- model was used to estimate the pooled prevalence of HIV-positive status disclosure. Heterogeneity and publication bias of included studies was determined using I2 and Egger’s test, respectively. Result From 601 records screened, nine relevant studies consisting of 2,442 HIV-positive children were included in the analysis. The overall pooled prevalence of HIV-positive status disclosure among children living with HIV/AIDS in Ethiopia was 31.2% (95% CI [23.9–38.5]). HIV-negative status of caregivers (AOR: 2.01; 95% CI [1.28–3.18]), long duration on ART (greater than 5 years) (AOR: 3.2; 95% CI [1.77–5.78]) and older age of the child (>10 years) (AOR: 7.2; 95% CI [4.37–11.88]) were significantly associated with HIV-positive status disclosure. Conclusion Low prevalence of pediatric HIV-positive status disclosure was observed in Ethiopia. The longer duration of ART, the HIV-negative status of the caregiver, and older age greater than 10 years were the predictors of pediatric HIV-positive status disclosure. Health system leaders and policymakers shall design training and counseling programs for healthcare professionals and caregivers to enhance their awareness about HIV-positive status disclosure. Trial registration This review was registered under PROSPERO and received a unique registration number, CRD42019119049.

Project description:BACKGROUND: The choice of infant feeding method is important for HIV-positive mothers in order to optimise the chance of survival of their infants and to minimise the risk of HIV transmission. The aim of this study was to investigate feeding practices, including breastfeeding, in the context of PMTCT for infants and children under two years of age born to HIV-positive mothers in Uganda. METHODS: In collaboration with The Aids Support Organisation Mbale, we conducted a cross-sectional survey involving 235 HIV-positive mothers in Uganda. Infant feeding practices, reasons for stopping breastfeeding, and breast health problems were studied. Breastfeeding duration was analysed using the Kaplan-Meier method based on retrospective recall. RESULTS: Breastfeeding was initiated by most of the mothers, but 20 of them (8.5%) opted exclusively for replacement feeding. Pre-lacteal feeding was given to 150 (64%) infants and 65 (28%) practised exclusive breastfeeding during the first three days. One-fifth of the infants less than 6 months old were exclusively breastfed, the majority being complementary fed including breast milk. The median duration of breastfeeding was 12 months (95% confidence interval [CI] 11.5 to 12.5). Adjusted Cox regression analysis indicated that a mother's education, socio-economic status, participation in the PMTCT-program and her positive attitude to breastfeeding exclusively, were all associated with a reduction in breastfeeding duration. Median duration was 3 months (95% CI 0-10.2) among the most educated mothers, and 18 months (95% CI 15.0-21.0) among uneducated mothers. Participation in the PMTCT program and being socio-economically better-off were also associated with earlier cessation of breastfeeding (9 months [95% CI 7.2-10.8] vs. 14 months [95% CI 10.8-17.2] and 8 months [95% CI 5.9-10.1] vs. 17 months [95% CI 15.2-18.8], respectively). The main reasons for stopping breastfeeding were reported as: advice from health workers, maternal illness, and the HIV-positive status of the mother. CONCLUSION: Exclusive breastfeeding was uncommon. Exclusive replacement feeding was practised by few HIV-positive mothers. Well-educated mothers, mothers who were socio-economically better-off and PMTCT-attendees had the shortest durations of breastfeeding. Further efforts are needed to optimise infant feeding counselling and to increase the feasibility of the recommendations.

Project description:IntroductionGlobally, over 90% of HIV infections among children are due to mother-to-child transmission and breastfeeding accounts for 5-20% of the burden. Avoidance of inappropriate feeding practices and practicing exclusive breastfeeding is recommended to reduce mother-to-child HIV transmission, but it is hardly practiced. The aim of this study was to determine the prevalence of exclusive breastfeeding practice and associated factors among HIV-positive mothers attending governmental PMTCT clinics in Southern Ethiopia.MethodsAn institution-based cross-sectional study was conducted from April to May 2019. The participants of the study were 209 HIV-positive mothers at the selected PMTCT sites. The study subjects were drawn from 10 health institutions located at 6 towns in Southern Ethiopia which constituted six hospitals and four health centers. Quantitative data were collected using the pretested structured questionnaire. Logistic regression analysis was used to determine the association between the predictors and outcome variable.ResultsAmong the 209 participants, 81.6% (95% CI: 75.8-86.5) practiced exclusive breastfeeding and 18.4% (95% CI: 13.5-23.7) practiced mixed feeding. Mothers who had attended the recommended four antenatal visits [AOR: 3.01, 95% CI (1.1-8.28)], who had disclosed their serostatus [AOR: 3.17, 95% CI (1.12-8.99)], who had sufficient knowledge about infant feeding practice [AOR: 3.32, 95% CI (1.15-9.55)], and favorable attitude towards infant feeding practice [AOR: 5.39, 95% CI (1.65-17.6)] were more likely to practice exclusive breastfeeding.ConclusionExclusive breastfeeding was predominantly practiced. But mixed feeding was also being practice considerably. Improving maternal knowledge and attitude towards appropriate infant feeding practice through appropriate counseling on ANC visits could significantly improve EBF practice. It was also evident that promoting disclose of serostatus could empower the mothers to make an informed decision on how to appropriately feed their newborn.

Dataset Information

Infant Feeding Practices of HIV Positive Mothers and Its Association with Counseling and HIV Disclosure Status in Ethiopia: A Systematic Review and Meta-Analysis.

Introduction

Methods

Result

Conclusion

Publications

Infant Feeding Practices of HIV Positive Mothers and Its Association with Counseling and HIV Disclosure Status in Ethiopia: A Systematic Review and Meta-Analysis.

Similar Datasets

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