Sociocultural factors influencing infant-feeding choices among African immigrant women living with HIV: A synthesis of the literature

J Am Assoc Nurse Pract. 2018 Apr;30(4):208-235. doi: 10.1097/JXX.0000000000000014.


Background and purpose: The World Health Organizations (WHO) strategy is to eliminate pediatric HIV. HIV prevention guidelines in high-income countries recommend mothers living with HIV avoid breastfeeding. Yet, breastfeeding is promoted as the normal and unequalled method of feeding infants. This creates a paradox for mothers coming from cultures where breastfeeding is an expectation and formula feeding suggests illness. Therefore, the purpose of this literature review is to examine the context influencing infant feeding among African immigrant women living with HIV to develop interventions to reduce the risk of HIV mother-to-child transmission.

Methods: Using the PEN-3 cultural model as a guide, we selected 45 empirical studies between 2001 and 2016 using 5 electronic databases on the sociocultural factors influencing infant-feeding choices and practices among African women from HIV endemic countries.

Conclusions: Findings are congruent with the importance of culture when developing guidelines. Our review provides support that culture-centered interventions are crucial toward achieving the WHO's strategy to eliminate pediatric HIV.

Implications for practice: Understanding the sociocultural determinants of infant-feeding choices is critical to the development of prevention initiatives to eliminate pediatric HIV.

Publication types

  • Review

MeSH terms

  • Breast Feeding*
  • Emigrants and Immigrants*
  • Female
  • HIV Infections / transmission*
  • Humans
  • Infant
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical*