Exclusive breast-feeding promotion among HIV-infected women in South Africa: An Information-Motivation-Behavioural Skills model-based pilot intervention

Emily L. Tuthill, Lisa M. Butler, Jennifer A. Pellowski, Jacqueline M. McGrath, Regina M. Cusson, Robert K. Gable, Jeffrey D. Fisher

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Objective Exclusive breast-feeding (EBF) provides optimal nutrition for infants and mothers. The practice of EBF while adhering to antiretroviral medication decreases the risk of mother-to-child transmission of HIV from approximately 25 % to less than 5 %. Thus the WHO recommends EBF for the first 6 months among HIV-infected women living in resource-limited settings; however, EBF rates remain low. In the present study our aim was to design and implement a pilot intervention promoting EBF among HIV-infected women. Design The Information-Motivation-Behavioural Skills (IMB) model was applied in a brief motivational interviewing counselling session that was tested in a small randomized controlled trial. Setting Pietermaritzburg, South Africa, at two comparable rural public health service clinics. Subjects Sixty-eight HIV-infected women in their third trimester were enrolled and completed baseline interviews between June and August 2014. Those randomized to the intervention arm received the IMB-based pilot intervention directly following baseline interviews. Follow-up interviews occurred at 6 weeks postpartum. Results While not significantly different between trial arms, high rates of intention and practice of EBF at 6-week follow-up were reported. Findings showed high levels of self-efficacy being significantly predictive of breast-feeding initiation and duration regardless of intervention arm. Conclusions Future research must account for breast-feeding self-efficacy on sustaining breast-feeding behaviour and leverage strategies to enhance self-efficacy in supportive interventions. Supporting breast-feeding behaviour through programmes that include both individual-level and multi-systems components targeting the role of health-care providers, family and community may create environments that value and support EBF behaviour.

Original languageEnglish (US)
Pages (from-to)1481-1490
Number of pages10
JournalPublic Health Nutrition
Issue number8
StatePublished - Jun 1 2017
Externally publishedYes


  • Exclusive breast-feeding
  • HIV
  • Infant feeding
  • Information-Motivation-Behavioural Skills
  • Mother-to-child transmission of HIV
  • South Africa

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Nutrition and Dietetics
  • Medicine (miscellaneous)


Dive into the research topics of 'Exclusive breast-feeding promotion among HIV-infected women in South Africa: An Information-Motivation-Behavioural Skills model-based pilot intervention'. Together they form a unique fingerprint.

Cite this