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

Josephine Etowa, Egbe Etowa, Hilary Nare, Ikenna Mbagwu and Jean Hannan
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Josephine Etowa: School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada
Egbe Etowa: Department of Sociology, Anthropology & Criminology, Faculty of Arts, Humanities & Social Sciences, University of Windsor, Windsor, ON N9B 3P4, Canada
Hilary Nare: School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada
Ikenna Mbagwu: School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada
Jean Hannan: Nicole Wertheim College of Nursing and Health Sciences, Academic Centre 3, Florida International University, Miami, FL 33199, USA

IJERPH, 2020, vol. 17, issue 18, 1-13

Abstract: 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: breastfeeding; black mothers; HIV/AIDs; infant feeding guidelines (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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