Commonalities and differences in infant feeding attitudes and practices in the context of HIV in sub-Saharan Africa: A metasynthesis

Emily Tuthill, Jacqueline McGrath, Sera Young

Research output: Contribution to journalArticlepeer-review

43 Scopus citations


Exclusive breastfeeding (EBF) has been identified as a key intervention to promote infant health and to reduce the vertical transmission of HIV. Despite this knowledge and increased resources to promote EBF, the practice in sub-Saharan Africa (SSA) remains low among HIV+ women. Although a number of qualitative studies have been conducted throughout SSA, the influences on and consequences of infant feeding choices of HIV+ mothers' findings have not been regarded systematically. Therefore, our objective was to identify overarching themes, commonalities, and differences in infant feeding choices among qualitative studies with HIV+ mothers in SSA. Sixteen qualitative studies of infant feeding practices in the context of HIV were identified. Noblit and Hare's seven-step metasynthesis methodology was used to analyze the experiences of HIV+ women and those who provide infant feeding services/counseling. Data were available from approximately 920 participants (i.e., 750 HIV+ mothers, 109 health-care providers, and 62 family members) across 13 SSA countries from 2000 to 2011. From these data, five themes emerged within which 3-4 overarching key metaphors were identified. The consistency of key metaphors across a variety of geographic, economic, and cultural settings suggest the importance of approaching infant feeding holistically, within the context of maternal knowledge, health-care support, family resources, and cultural expectations. EBF campaigns in SSA are more likely to successfully support optimal health for infants and a safe supportive environment for their mothers when the impact of infant feeding decisions are evaluated across these themes.

Original languageEnglish (US)
Pages (from-to)214-225
Number of pages12
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Issue number2
StatePublished - Jan 1 2014
Externally publishedYes


  • Africa
  • HIV
  • breastfeeding
  • metasynthesis
  • mother-to-child transmission
  • vertical transmission

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health
  • Social Psychology


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