BACKGROUND WHO guidelines recommend breastfeeding for mothers living with HIV adherent to antiretroviral therapy in countries where formula is not accessible. In Canada and the US, guidelines for mothers living with HIV recommend exclusive formula feeding. Awareness of national infant feeding guidelines and socio-cultural factors influence infant feeding choices that may result in an increased risk of vertical transmission of HIV. The purpose of this paper is to present factors associated with awareness of guidelines among Black mothers living with HIV. Data were derived from a survey conducted as part of a recent international study that examined infant feeding practices among Black women living with HIV in Ottawa, Canada; Port Harcourt, Nigeria; and Miami, Florida. METHODS Participants (n = 690) from Port Harcourt (n = 400), Miami (n = 201), and Ottawa (n = 89) were surveyed on their awareness of infant feeding guidelines for mothers living with HIV. Data were collected between November, 2016 and March, 2018. RESULTS Participants' mean ages were 34.3 ± 5.9 years. Across all sites, 15.4% (95% CI 13.2, 7.7) of mothers were NOT aware of their country's infant feeding guidelines. Cultural beliefs (OR = 0.133, p = 0.004, 95% CI 0.03, 0.53) and functional social support influenced infant feeding choices (OR = 1.1, p = 0.034, 95% CI 1.01, 1.20) and were statistically significant predictors of guideline awareness (Χ2 = 38.872, p < .05) after controlling for age, years of formal education, marital status, and country of residence. As agents of functional social support, family members and health workers (e.g., nurses, physicians, social workers, other health care workers) influenced participants' awareness of infant feeding guidelines and guided them in their infant feeding choices. CONCLUSIONS Among participants, awareness of national infant feeding guidelines was associated with functional social support and cultural beliefs influenced infant feeding choices. Therefore, culturally adapted messaging via social supports already identified by mothers, including family relationships and health workers, is an appropriate way to enhance awareness of infant feeding guidelines. Ultimately, contributing to the global health goals of maternal health and reduced infant mortality.

中文翻译：

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在北美和尼日利亚，感染艾滋病毒的母亲对婴儿喂养的准则有所了解。

背景技术世卫组织指南建议在无法获得配方奶粉的国家中，对坚持抗逆转录病毒疗法的HIV感染母亲进行母乳喂养。在加拿大和美国，针对感染艾滋病毒的母亲的指南建议采用独家配方奶粉喂养。对国家婴儿喂养准则和社会文化因素的了解会影响婴儿喂养的选择，这可能会导致艾滋病毒垂直传播的风险增加。本文的目的是介绍与感染艾滋病毒的黑人母亲有关准则意识的相关因素。数据来自一项最近的国际研究的一部分，该研究调查了加拿大渥太华感染艾滋病毒的黑人妇女的婴儿喂养方式；尼日利亚哈科特港；和佛罗里达州的迈阿密。方法参加者来自迈阿密的Harcourt港（n = 400），n = 201的690位参与者，对渥太华和渥太华（n = 89）进行了调查，了解他们对感染艾滋病毒的母亲的婴儿喂养准则的认识。数据收集于2016年11月至2018年3月。结果参与者的平均年龄为34.3±5.9岁。在所有地点，有15.4％（95％CI 13.2，7.7）的母亲不知道他们所在国家的婴儿喂养准则。文化信仰（OR = 0.133，p = 0.004，95％CI 0.03，0.53）和功能性社会支持影响婴儿的喂养选择（OR = 1.1，p = 0.034，95％CI 1.01，1.20），是指导性意识的统计显着预测指标（Χ2= 38.872，p <.05）在控制了年龄，接受正规教育的年限，婚姻状况和居住国之后。作为功​​能性社会支持的代理人，家庭成员和卫生工作者（例如，护士，医生，社会工作者，其他卫生保健工作者）影响了参与者对婴儿喂养准则的认识，并指导他们选择婴儿喂养方式。结论在参与者中，对国家婴儿喂养指南的了解与功能性社会支持有关，文化信仰影响婴儿喂养的选择。因此，通过母亲已经确定的社会支持，包括家庭关系和卫生工作者，通过文化适应性的信息传递是增强对婴儿喂养准则的认识的适当方法。最终，有助于实现孕产妇保健和降低婴儿死亡率的全球卫生目标。对国家婴儿喂养准则的认识与功能性社会支持有关，文化信仰影响婴儿喂养的选择。因此，通过母亲已经确定的社会支持，包括家庭关系和卫生工作者，通过文化适应性的信息传递是增强对婴儿喂养准则的认识的适当方法。最终，有助于实现孕产妇保健和降低婴儿死亡率的全球卫生目标。对国家婴儿喂养准则的认识与功能性社会支持有关，文化信仰影响婴儿喂养的选择。因此，通过母亲已经确定的社会支持，包括家庭关系和卫生工作者，通过文化适应性的信息传递是提高对婴儿喂养准则的认识的适当方法。最终，有助于实现孕产妇保健和降低婴儿死亡率的全球卫生目标。