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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
xii
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
1
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.
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