Factors Affecting Breastfeeding Cessation Among HIV-Positive Mothers in Kisumu, Kenya

Background: Approximately 20% of all perinatal HIV transmission occurs during the postpartum period. In the Kisumu Breastfeeding Study, antiretroviral therapy (ART) is provided during the intrauterine and intrapartum periods, and the first six months of the postpartum period. The study staff counsels women to practice exclusive breastfeeding then wean over two weeks before ART is discontinued at six months. ART is continued for women who meet WHO treatment criteria.

Objective: To do a preliminary evaluation of factors which may influence a mother's decision to comply or not comply with the study recommendation to stop breastfeeding when ART is discontinued in order to guide further formative work.

Methods: We used semi-structured interviews of 18 mothers participating in the study. By interviewing 10 mothers who stopped breastfeeding and 8 mothers who continued, it was possible to examine factors that may have influenced the two groups.

Results: Participants who stopped breastfeeding received more family support (100% vs. 0%), were more educated (75% vs. 25% attended high school), and were more likely to disclose their HIV status (80% vs. 63%). All women stated that it was not traditional to stop breastfeeding at six months, and that it could be stigmatizing. More participants who continued breastfeeding were concerned about stigma (50% vs. 10%).

Conclusion: This study has suggested that family support, education, and traditional norms are important factors influencing a mother's decision regarding breastfeeding cessation. Thus, counseling and family support may play integral roles in the promotion of early breastfeeding cessation. Further evaluation is necessary.