HIV in Malawi

Many mothers in Malawi struggle against combating the contracting and transmission of HIV. This is because the number of HIV cases in Malawi is high. Many of these cases being mothers with small children, who have been seen to transmit HIV to their children through breast feeding. Upon hearing this the simple solution of just do not breastfeed children comes to the minds of everyone hearing of this unfortunate occurrence. However in Malawi the cessation of  breastfeeding comes with many other attached questions, issues, or cultural stigmas. These start with the fact that the World Health Organization has released a number of protocols surrounding breastfeeding often stating an infant should be breastfed for the first six months to year of their life, then some say they should not be breastfed at all. This mix of protocols not only confuse the mothers on how they should handle themselves, but also can create a level of mistrust of the outside medical authority. This may lead them to instead trust the advise of a local, more medically uneducated medical doctor or advisor. Culturally this can be a huge decision for mothers since a large part of their social identity revolves around caring for their children. Also formula is very expensive in this part of the world, so if an infant is going hungry and a mother is producing milk she might choose to take the risk and breastfeed her child in order to prevent it from starving.

In one study, the anthropologist traveled to the urban area of Malawi in order to investigate the risk of HIV transmission through breastfeeding. Their driving factor in studying and assessing the risk factor was that they believed that if they could provide better knowledge of the level of risk and the timing of infant HIV infection throughout the breastfeeding period it can better inform women of the risky behaviors they were engaging in and asses policy options about breastfeeding by HIV infected women. This was done by studying the children of HIV infected mothers who had previously participated in a clinical trial of birth canal cleansing in order to prevent HIV transmission during birth and contaminating their research.  What they found was that the incidence of breastfed infants by age and maternal and infant risk factors for HIV transmission , using hazard models to risk ratios indicated that the majority of children became infected through breastfeeding, and the proportions increased as the amount of months they were breastfed for. The only factors associated with low risk of postnatal HIV transmission was an older maternal age.

 

http://jama.jamanetwork.com/article.aspx?articleid=191323

 

Citations:

Miotti, Paolo, Newton Kumwenda, Robert Broadhead, and George Liomba. “HIV Transmission Through Breastfeeding.” JAMA Network. January 1, 1999. Accessed August 8, 2014.

 

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