SUMMARY

HIV has direct effect on child nutrition, the choice of Infant and Young Child Feeding in

the context of HIV has significant effect on optimal child growth, survival and

development. In the absence of any interventions, 5-20% of infants born to HIV infected

women will be infected through breastfeeding. This study determined the level of

adherence to recommended infant feeding option among HIV positive Mothers attending

post-natal services in health facilities in Abuja. A cross sectional descriptive study was

conducted among 404 randomly selected HIV positive mothers attending postnatal clinic

in    Abuja. Pre-tested interviewer administered structured questionnaire was used to

collect data and analysis was done using Epi-info software. Chi-square and Odd ratio

were used to determine associations while p-value was set at 0.05.

The study found that a third of the respondents, 135 (33.4%) were within the age range of

30 – 34years. 68 (16.8%) had followed the recommended infant feeding practice while

about a third (30.4%) had practiced mixed feeding. Predictors of adherence were found to

be good knowledge (p=0.001), attendance of ANC at secondary facility (p=0.01) and

employment status of respondents (p=0.01), were found to be independently associated

(p-value of < 0.05) with Adherence

Conclusion: Seventy-three (73%) of respondents attended Antenatal Care at secondary

health facility. Majority (93%) of the respondents have good knowledge, fair (42%)

attitude and low adherence (16.8%) to the recommended feeding option. Predictors of

adherence were good knowledge, type of health facility and employment.

Key Words: Adherence to Infant feeding, Mothers, HIV Positive

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CHAPTER ONE

INTRODUCTION

1.1 Background

Infant and Young Child Feeding (IYCF) is very critical for child survival, especially in

the presence of HIV. While HIV has direct effect on childhood nutrition, the choice of

Infant and Young Child Feeding in the context of HIV has significant effect on optimal

child growth, survival and development. Hiv/AIDs is one of the world‟s most serious

public health and developmental challenges. It was first reported in 1981 and primarily

affects those in their most productive years 15-29years. Hiv not only affects the health of

individuals, it affects households, communities, the development and economic growth of

countries. Many of the countries hardest hit by HIV also suffer from other infectious

diseases, food insecurity and other serious problems.1

Globally, in 2015, there were 36.7 million people living with HIV, up from 33.3million

in 2010 which is partly due to new infections, people living longer and general

population growth. About 70% of people living with HIV/AIDS were in Sub-Saharan

Africa of these 51% but only constitute 13% of the world population.1,2,3 were women.

As at December 2015 there were 1.8million children under the age of 15 living with

Human Immunodeficiency Virus (HIV).1

In Nigeria, the epidemiology of HIV is mainly informed by two national surveys, the

Antenatal clinic (ANC) survey conducted among pregnant women and the National

HIV/AIDS Reproductive Health Survey (NARHS) which is a general population-based

survey. The national HIV and syphilis sero prevalence sentinel survey among pregnant

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women attending ANC in Nigeria 2014 reported a national prevalence of 3.0%.4 The

national prevalence of HIV is 3.0% with over 3.2 million people living with HIV/AIDS

and about 58% are women. The 2010 mode of transmission study for HIV in Nigeria

reported Mother to Child Transmission route as 10%, and Sexual route for 80%. More

than 90 percent of HIV infections in children are as a result of mother-to-child-

transmission, where the virus is passed from a mother living with HIV to her baby during

pregnancy, childbirth or during breastfeeding. While the precise mechanisms for viral

transmission during pregnancy are incompletely understood, the risk of this form of

transmission increases in direct relation to the severity of the mother‟s HIV infection.5

Without intervention to prevent mother-to-child transmission, 30-45% of infants born to

HIV-positive mothers become infected during pregnancy, delivery and breastfeeding6.

Breastfeeding for women living with HIV can be made safer by providing antiretroviral

drugs throughout this period.