The study assessed the perspectives of HIV-positive mothers and family members (grand-mothers and fathers) of the infant feeding options recommended for HIV-infected mothers in Ghana. This entailed individual interviews with 40 HIV-positive mothers with infants aged 0 to 12 months and 6 focus group discussions with HIV-positive mothers, fathers and grandmothers of unknown status in two urban districts. All infants born to HIV-positive mothers in both districts had been breastfed. Breastfeeding was initiated between three hours and three days following birth. While some of the infants had been exclusively breast-fed, none had been exclusively formula fed. Early mixed feeding patterns were deeply entrenched. Barriers to exclusive replacement feeding by HIV-positive mothers included cultural and familial influences, socio-economic factors including cost of infant formula, lack of access to fridges, clean water and fuel. Interventions designed to promote safer infant feeding among HIV-infected mothers in these settings need to be mindful of these barriers (socio-economic, cultural and familial) that these women face. Failure by policy makers to incorporate these issues will continue to lead to a gap between well-intended policies and programmes, and actual practices of HIV-positive mothers.
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Laar et al. (2011) studied this question.