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

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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)

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.

Suggested Citation

  • Josephine Etowa & Egbe Etowa & Hilary Nare & Ikenna Mbagwu & Jean Hannan, 2020. "Social Determinants of Breastfeeding Preferences among Black Mothers Living with HIV in Two North American Cities," IJERPH, MDPI, vol. 17(18), pages 1-13, September.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:18:p:6893-:d:416685
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    References listed on IDEAS

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    1. Wolf, J.H., 2003. "Low Breastfeeding Rates and Public Health in the United States," American Journal of Public Health, American Public Health Association, vol. 93(12), pages 2000-2010.
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