Exclusive breast-feeding promotion among HIV-infected women in South Africa: an Information-Motivation-Behavioural Skills model-based pilot intervention.
OBJECTIVE
Exclusive breast-feeding (EBF) provides optimal nutrition for infants and mothers. The practice of EBF while adhering to antiretroviral medication decreases the risk of mother-to-child transmission of HIV from approximately 25 % to less than 5 %. Thus the WHO recommends EBF for the first 6 months among HIV-infected women living in resource-limited settings; however, EBF rates remain low. In the present study our aim was to design and implement a pilot intervention promoting EBF among HIV-infected women.


METHODS
The Information-Motivation-Behavioural Skills (IMB) model was applied in a brief motivational interviewing counselling session that was tested in a small randomized controlled trial.


METHODS
Pietermaritzburg, South Africa, at two comparable rural public health service clinics.


METHODS
Sixty-eight HIV-infected women in their third trimester were enrolled and completed baseline interviews between June and August 2014. Those randomized to the intervention arm received the IMB-based pilot intervention directly following baseline interviews. Follow-up interviews occurred at 6 weeks postpartum.


RESULTS
While not significantly different between trial arms, high rates of intention and practice of EBF at 6-week follow-up were reported. Findings showed high levels of self-efficacy being significantly predictive of breast-feeding initiation and duration regardless of intervention arm.


CONCLUSIONS
Future research must account for breast-feeding self-efficacy on sustaining breast-feeding behaviour and leverage strategies to enhance self-efficacy in supportive interventions. Supporting breast-feeding behaviour through programmes that include both individual-level and multi-systems components targeting the role of health-care providers, family and community may create environments that value and support EBF behaviour.
1School of Nursing,University of California,San Francisco,2 Koret Way,San Francisco,CA 94143,USA.
Emily L
http://orcid.org/0000-0001-6729-4101
EL
Tuthill
2Institute for the Collaboration on Health,Intervention and Policy,University of Connecticut,Storrs,CT,USA.
Lisa M
LM
Butler
3Department of Psychiatry and Human Behavior,The Warren Alpert Medical School,Brown University,Providence,RI,USA.
Jennifer A
JA
Pellowski
4School of Nursing,University of Connecticut,Storrs,CT,USA.
Jacqueline M
JM
McGrath
4School of Nursing,University of Connecticut,Storrs,CT,USA.
Regina M
RM
Cusson
6Center for Research and Evaluation,College of Arts & Sciences,Johnson & Wales University,Providence,RI,USA.
Robert K
RK
Gable
2Institute for the Collaboration on Health,Intervention and Policy,University of Connecticut,Storrs,CT,USA.
Jeffrey D
JD
Fisher
D000328:Adult; D001942:Breast Feeding; D003376:Counseling; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections; D015438:Health Behavior; D006266:Health Education; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D009042:Motivation; D010865:Pilot Projects; D011634:Public Health; D012424:Rural Population; D018401:Sample Size; D012959:Socioeconomic Factors; D013019:South Africa; D016896:Treatment Outcome; D055815:Young Adult
Exclusive breast-feeding; HIV; Infant feeding; Information–Motivation–Behavioural Skills; Mother-to-child transmission of HIV; South Africa