RESUMEN
BACKGROUND: Prior to 2010, the World Health Organization recommended that HIV-positive mothers exclusively breastfeed for the first 6 months of life unless replacement feeding was acceptable, feasible, affordable, sustainable, and safe. Community pressure to practice mixed feeding, lack of knowledge on safe feeding, and shame regarding HIV status discourage mothers from breastfeeding exclusively and contribute to South Africa's low exclusive breastfeeding prevalence of 7% for infants under 6 months. OBJECTIVE: This pilot study explored the feasibility of implementing a feeding buddy system to provide a mother with support to achieve her infant feeding goal. METHODS: A convenience sample of 14 HIV-positive mothers and their buddies was recruited from the Butterworth Gateway Clinic in South Africa. HIV-positive mothers selected a buddy who accompanied them on clinic visits and counseling sessions on safe infant feeding. The research team conducted in-depth interviews to gather qualitative information on participants' experiences at 3 points in time. RESULTS: Buddy selection was influenced by the mother's relationship to the buddy, trust, and previous disclosure of HIV status. The 3 most cited forms of support were the buddy's accountability, teaching, and help in feeding the infant correctly. CONCLUSIONS: Buddies were successfully integrated into routine Prevention of Maternal-to-Child Transmission visits. Study participants confirmed that having a buddy was a helpful support for HIV-positive mothers.
Asunto(s)
Lactancia Materna/métodos , Amigos/psicología , Infecciones por VIH/psicología , Madres , Apoyo Social , Adulto , Lactancia Materna/psicología , Lactancia Materna/estadística & datos numéricos , Femenino , Conocimientos, Actitudes y Práctica en Salud , Promoción de la Salud , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Refrigeración , SudáfricaRESUMEN
OBJECTIVE: Compare the nutritional vulnerability, risk of malnutrition, nutritional status and quality of life (QoL) between recipients and non-recipients of nutrition care and support (NCS) of HIV-positive adults. METHODS: In 2009, a household-based cross-sectional study of HIV-positive adults, NCS recipients (n=97) and non-NCS recipients (n=203) from KwaZulu-Natal was conducted. Nutritional vulnerability (socio-economic status; food security; self-reported health status; nutritional knowledge and attitude), risk of malnutrition (nutrition assessment screening tool), anthropometry (body mass index; mid-upper arm circumference; waist-to-hip ratio) and QoL (general health; self-care; physical functioning) were compared between the two groups. RESULT: Although the result suggests a modest impairment of QoL, NCS recipients were twice as likely to have severe impairment of general health; self-care functioning and QoL. Overweight and obesity were common despite indications of high prevalence of food insecurity, possible-risk of malnutrition and diets predominantly of cereals. NCS recipients were more frequently taking anti-retroviral drugs, receiving social grants, reporting good eating plans and owning kitchen gardens. Non-NCS recipients had been generally sick, reported fatigue, nausea, appetite loss and diarrhoea. NCS recipients were twice as likely to experience oral thrush. CONCLUSION: Contextual factors such as low dietary diversity and household food insecurity that exacerbates nutritional vulnerability and malnutrition should be considered when providing NCS to fully achieve nutritional recovery and QoL of HIV-positive adults.