Knowledge, attitudes, and practices regarding exclusive breastfeeding among HIV-positive mothers in Uganda: A qualitative study

Background In Uganda, the prevalence of human immunodeficiency virus (HIV) in pregnant women was estimated at 6.1% in 2009, and in 2011, mother-to-child transmission (MTCT) of HIV resulted in 20 600 new paediatric HIV infections. A total of 50% of MTCT of HIV in Uganda occurs after birth, and this is partially attributable to poor adherence to infant feeding (IF) guidelines. Poor IF practices contribute to approximately 1.4 million deaths in children aged younger than five. In 2011, Uganda's rate of exclusive breastfeeding (EBF) was 62% for infants aged 0 to 5 months. Identifying barriers provides information on how to improve support for HIV-positive mothers' adherence to EBF, which may take the form of targeted interventions. Aim This study explores the knowledge, attitudes, and practices of HIV-positive mothers in Kampala, Uganda, regarding EBF of infants aged younger than 6 months. Methods Five focus group discussions, each consisting of five HIV-positive mothers, were carried out at Kawempe Home Care using a semi-structured guide. Thematic content analysis was used to analyse the data. Results The study findings showed that the main barriers to HIV-positive mothers practising EBF include a lack of IF counselling, fear of HIV transmission through breast milk, returning to work, and breastfeeding difficulties. The main factors influencing HIV-positive mothers' decisions regarding IF are IF counselling and partners' and families' recommendations. Conclusion This study recommends increasing access to couples-based HIV testing at antenatal clinics and couples-based IF counselling, while ensuring that it addresses breastfeeding difficulties.