TY - JOUR
T1 - An education and counseling program for preventing breast-feeding- associated HIV transmission in Zimbabwe
T2 - Design and impact on maternal knowledge and behavior
AU - Piwoz, Ellen G.
AU - Iliff, Peter J.
AU - Tavengwa, Naume
AU - Gavin, Lorrie
AU - Marinda, Edmore
AU - Lunney, Kevin
AU - Zunguza, Clare
AU - Nathoo, Kusum J.
AU - Humphrey, Jean H.
N1 - Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2005/4
Y1 - 2005/4
N2 - International guidance on HIV and infant feeding has evolved over the last decade. In response to these changes, we designed, implemented, and evaluated an education and counseling program for new mothers in Harare, Zimbabwe. The program was implemented within the ZVITAMBO trial, in which 14,110 mother-baby pairs were enrolled within 96 h of delivery and were followed at 6 wk, 3 mo, and 3-mo intervals. Mothers were tested for HIV at delivery but were not required to learn their test results. Infant feeding patterns were determined using data provided up to 3 mo. Formative research was undertaken to guide the design of the program that included group education, individual counseling, videos, and brochures. The program was introduced over a 2-mo period: 11,362, 1311, and 1437 women were enrolled into the trial before, during, and after this period. Exclusive breast-feeding was recommended for mothers of unknown or negative HIV status, and for HIV-positive mothers who chose to breast-feed. A questionnaire assessing HIV knowledge and exposure to the program was administered to 1996 mothers enrolling after the program was initiated. HIV knowledge improved with increasing exposure to the program. Mothers who enrolled when the program was being fully implemented were 70% more likely to learn their HIV status early (<3 mo) and 8.4 times more likely to exclusively breast-feed than mothers who enrolled before the program began. Formative research aided in the design of a culturally sensitive intervention. The intervention increased relevant knowledge and improved feeding practices among women who primarily did not know their HIV status.
AB - International guidance on HIV and infant feeding has evolved over the last decade. In response to these changes, we designed, implemented, and evaluated an education and counseling program for new mothers in Harare, Zimbabwe. The program was implemented within the ZVITAMBO trial, in which 14,110 mother-baby pairs were enrolled within 96 h of delivery and were followed at 6 wk, 3 mo, and 3-mo intervals. Mothers were tested for HIV at delivery but were not required to learn their test results. Infant feeding patterns were determined using data provided up to 3 mo. Formative research was undertaken to guide the design of the program that included group education, individual counseling, videos, and brochures. The program was introduced over a 2-mo period: 11,362, 1311, and 1437 women were enrolled into the trial before, during, and after this period. Exclusive breast-feeding was recommended for mothers of unknown or negative HIV status, and for HIV-positive mothers who chose to breast-feed. A questionnaire assessing HIV knowledge and exposure to the program was administered to 1996 mothers enrolling after the program was initiated. HIV knowledge improved with increasing exposure to the program. Mothers who enrolled when the program was being fully implemented were 70% more likely to learn their HIV status early (<3 mo) and 8.4 times more likely to exclusively breast-feed than mothers who enrolled before the program began. Formative research aided in the design of a culturally sensitive intervention. The intervention increased relevant knowledge and improved feeding practices among women who primarily did not know their HIV status.
KW - Breast-feeding
KW - Exclusive breast-feeding
KW - HIV
KW - Mother to child transmission
KW - Zimbabwe
UR - http://www.scopus.com/inward/record.url?scp=16244398688&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=16244398688&partnerID=8YFLogxK
U2 - 10.1093/jn/135.4.950
DO - 10.1093/jn/135.4.950
M3 - Article
C2 - 15795468
AN - SCOPUS:16244398688
SN - 0022-3166
VL - 135
SP - 950
EP - 955
JO - Journal of Nutrition
JF - Journal of Nutrition
IS - 4
ER -