BMJ Open 3:e003749 doi:10.1136/bmjopen-2013-003749
    • Research

Knowledge, attitudes and practices regarding infant feeding among HIV-infected pregnant women in Gaborone, Botswana: a cross-sectional survey

  1. John Ehiri4
  1. 1School of Population, Community & Behavioural Sciences, University of Liverpool, Liverpool, UK
  2. 2Botswana-Harvard School of Public Health, AIDS Institute Partnership, Gaborone, Botswana
  3. 3Department of Social Medicine & Health Service Management, Third Military Medical University, Chongqing, China
  4. 4Division of Health Promotion Sciences/Global health Institute, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
  1. Correspondence to Professor John Ehiri; jehiri{at}
  • Received 7 August 2013
  • Revised 7 November 2013
  • Accepted 7 November 2013
  • Published 29 November 2013


Objectives To assess knowledge, attitudes and practices regarding infant feeding among HIV-positive pregnant women in Gaborone, Botswana, and factors that influence their infant feeding choices.

Design A cross-sectional study.

Methods and study setting A questionnaire survey of 96 HIV-positive pregnant women attending four public infectious disease control clinics in Gaborone, Botswana.

Results Only about half of the study participants had knowledge about prevention of mother-to-child transmission (PMTCT) services related to breastfeeding, and very few (19.8%) chose to breastfeed their infants exclusively. Results of multiple logistic regression analysis showed that receiving infant feeding counselling as part of the PMTCT programme was significantly associated with a decision to exclusively breastfeed (OR (95% CI) 5.38 (1.83 to 15.81)). Similarly, HIV-positive pregnant women who received breastfeeding counselling through the PMTCT programme had higher knowledge of PMTCT practices related to appropriate infant feeding (OR (95% CI) 5.91 (1.06 to 34.31)). Women who did not express concern about HIV stigma had significantly higher knowledge of PMTCT practices related to infant feeding (OR (95% CI) 5.91 (1.69 to 15.56)). Knowledge of PMTCT practices related to breastfeeding was negatively associated with the belief that breastfeeding could transmit HIV to the baby (OR (95% CI) 9.73 (3.37 to 28.08)).

Conclusions Knowledge, attitudes and practices related to breastfeeding among HIV-positive pregnant women need further improvement, and the PMTCT programme should strengthen infant feeding counselling services to assist HIV-positive mothers in making informed and appropriate decisions regarding infant feeding.

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