AEGiS-15IAC: Taking counsel from women: towards a women-centered PMTCT counseling practice.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Taking counsel from women: towards a women-centered PMTCT counseling practice.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. WeOrD1256)

Gordon J, Bombardella P
Infant Feeding Research Project, Cape Town, South Africa

ISSUES: Although it is well known that HIV can be transmitted through breast milk, recent clinical studies have shown that this risk increases through mixed feeding. As such, UNAIDS/UNICEF/WHO recommends either exclusive breast feeding or exclusive formula feeding for a period of 4 - 6 months. As a result of these findings infant feeding counseling within the PMTCT programmes is based on the notions of informed choice and exclusivity. However, we will be problematising these three concepts - central to global policy guidelines - within the southern African context (Swaziland, South Africa and Namibia) based on qualitative research in nine sites over a seven month period.

DESCRIPTION: Despite the implementation of PMTCT programmes the predominant feeding pattern employed across all nine sites remains mixed. This poster draws on case studies that show the practical situational strategies that women employ with regards to infant feeding practices in contexts of HIV/AIDS, poverty and gender inequality.

LESSONS LEARNED: The data shows how the PMTCT counseling in the sites under study glosses the quotidian realities within which mothers can only respond to their infants' needs by taking advantage of whatever opportunities arise as they lack the stability needed to implement the long term, fixed and exclusive feeding approaches that the counseling prescribes. PMTCT interventions introduce mothers to unrealisable global guidelines which ultimately result in their alienation from the health care setting. Recommendation: PMTCT counseling should credit mothers with knowing what the obstacles to exclusive feeding are as well as knowing how best to overcome them. Counseling should be participatory rather than didactic and prescriptive as this would reposition mothers as part of the solution rather than as part of the problem.

Keywords: AEGIS, Counseling, Breast Feeding, Acquired Immunodeficiency Syndrome, Milk, Human, Mothers, Bottle Feeding, HIV Seropositivity, Demography, Health Planning Guidelines, Socioeconomic Factors, South Africa, Swaziland, Namibia, Humans, Female, Infant, prevention & control, organization & administration, therapy

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WeOrD1256