Social Determinants of Breastfeeding Preferences among Black Mothers Living with HIV in Two North American Cities

Int J Environ Res Public Health. 2020 Sep 21;17(18):6893. doi: 10.3390/ijerph17186893.


The study is motivated by the need to understand the social determinants of breastfeeding attitudes among HIV-positive African, Caribbean, and Black (ACB) mothers. To address the central issue identified in this study, analysis was conducted with datasets from two North American cities, where unique country-specific guidelines complicate infant feeding discourse, decisions, and practices for HIV-positive mothers. These national infant feeding guidelines in Canada and the US present a source of conflict and tension for ACB mothers as they try to navigate the spaces between contradictory cultural expectations and national guidelines. Analyses in this paper were drawn from a broader mixed methods study guided by a community-based participatory research (CBPR) approach to examine infant feeding practices among HIV-positive Black mothers in three countries. The survey were distributed through Qualtrics and SPSS was used for data cleaning and analysis. Results revealed a direct correlation between social determinants and breastfeeding attitude. Country of residence, relatives' opinion, healthcare providers' advice and HIV-related stigma had statistically significant association with breastfeeding attitude. While the two countries' guidelines, which recommend exclusive formula feeding, are cardinal in preventing vertical transmission, they can also be a source of stress. We recommend due consideration of the cultural contexts of women's lives in infant feeding guidelines, to ensure inclusion of diverse women.

Keywords: HIV/AIDs; black mothers; breastfeeding; infant feeding guidelines.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Breast Feeding*
  • Canada
  • Caribbean Region
  • Cities
  • Female
  • HIV Infections* / transmission
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Infant
  • Infectious Disease Transmission, Vertical
  • Mothers
  • Social Determinants of Health*
  • United States

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