Maternal knowledge on mother-to-child transmission of HIV and breastmilk alternatives for HIV postive mothers in Homa Bay District Hospital, Kenya

Background: Mother- to- Child Transmission (MTCT) of HIV is a relatively new concept in rural populations and despite the huge amount of work that has been done on the HIV/AIDS, there still remains a dearth of information in knowledge of mothers on this concept especially in areas related to appropriate feeding methods for infants born to mothers infected with the virus. Objectives: To determine maternal knowledge on MTCT of HIV in the rural setting and to examine viable breastmilk alternatives for mothers who would be HIV positive. Design: A cross- sectional study, supported by an observational study. Setting: A rural district community and Homa-Bay District Hospital in South Western Kenya. Subjects: One hundred and twelve non-tested mothers having infants aged 0-12 months in the community and a sub-group (10%) of HIV positive mothers from the District Hospital. Results: Maternal knowledge on MTCT of HIV was as low as 8.9% in the study area. The MTCT knowledge was found to influence the alternative feeding choice as mentioned by the non-tested mothers (p = 0.001; OR = l.41; 95%CI, 1.04-3.86). Those with high MTCT knowledge tended to be more receptive and considered feeding alternatives other than cowmilk like expressed breastmilk (p = 0.l 5), formula (p = 0.036; OR = 2.44; 95%CI, 1.66-6.04) and milk from milk bank (p = 0.0l5; OR = l.34; 95%CI, 1.13-5.50) than their counterparts with low MTCT knowledge. Cowmilk, formula and wet-nursing were the three feeding alternatives that were viable with varying socio-cultural, economic and/or nutritional constraints. Conclusion: Maternal MTCT knowledge influences the choice of alternative infant feeding option but not breastfeeding practices. Cowmilk is the most common, socio-culturally acceptable and accessible breastmilk alternative in this community. It is recommended that in order to improve MTCT knowledge, health education and nutrition counselling be intensified in PMTCT programmes, VCT centers and ANC clinics. Concurrently, effort should be made to increase the supply of cowmilk within the community so as to make it more readily available and affordable. The East African Medical Journal Vol. 83 (11) 2006: pp. 610-61