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APHA Scientific Session and Event Listing

Lucy Thairu, PhD, Center for African Studies, Stanford University, Encina Building West, Room 219, Stanford, CA 94305-8340, 650-723-8340, thairu@stanford.edu and Rwahungu Jumapili, Treatment and Research on AIDS Center of the Rwanda Ministry of Health, UNICEF-Rwanda Country Office Nutrition Section, Agence FACCO, Kigali, Rwanda.

Background: HIV-positive women make difficult infant feeding decisions: they have to balance the risk of infant morbidity and mortality from not breastfeeding against the risk of infection through breastfeeding. In line with the principle of “informed choice,” infected women have the right to receive information about the risks and benefits of each feeding option and the right to make a free choice. In Rwanda, women receive information from counselors in the national “Prevention of Mother-To-Child Transmission of HIV/AIDS” (PMTCT) program in public health facilities.

Purpose: To assess a) HIV-positive women's infant feeding choices and the information received and b) counselors knowledge of the options.

Methods: 3 PMTCT sites were randomly selected from each of the 12 provinces in Rwanda. In selected sites, all HIV-positive women were surveyed about their choices and about the information received (total: 706 women). In some of the 36 sites, open-ended interviews were conducted with counselors to find out their knowledge of the different options (total: 23 counselors).

Results: Most mothers had chosen to breastfeed. However, this choice was often not fully informed, as most mothers only recalled being presented with 2 infant feeding choices: to breastfeed or not to breastfeed. Counselors lacked knowledge about other infant feeding options.

Policy implications: For HIV-positive women in Rwanda to realize their right to information, the Ministry of Health and International Agencies are obliged to take the necessary steps to ensure the provision of education to counselors. Counselors will, in turn, be able to educate women about their options.

Learning Objectives: At the end of this session, participants in this session will be able to

• Identify challenges to applying the principle of “informed choice” in an African context.
• Understand the infant feeding choices made by HIV positive mothers in Rwanda based on limited information.
• Propose concrete steps to take in order for HIV positive mothers to realize their right to information.

Keywords: HIV Interventions, Breastfeeding

Presenting author's disclosure statement:

Not Answered