Zimbabwe: Program in Harare to Prevent HIV Transmission via Breastfeeding Is Effective

Johns Hopkins University Bloomberg School of Public Health researchers tested an education-based intervention to prevent HIV transmission via breastfeeding among new mothers in Harare, Zimbabwe. "International guidance on HIV and infant feeding has evolved over the last decade," wrote E.G. Piwoz and colleagues. "In response to these changes, we designed, implemented, and evaluated an education and counseling program for new mothers in Harare, Zimbabwe."

The investigators implemented the program within the ZVITAMBO trial, in which 14,110 mother-baby pairs were enrolled within 96 hours of delivery and were followed at 6 weeks, 3 months and 3-month intervals.

According to the report, "Mothers were tested for HIV at delivery but were not required to learn their test results. Infant-feeding patterns were determined using data provided up to 3 months. Formative research was undertaken to guide the design of the program that included group education, individual counseling, videos and brochures. The program was introduced over a 2-month period: 11,362, 1,311, and 1,437 women were enrolled into the trial before, during, and after this period."

"Exclusive breast-feeding was recommended for mothers of unknown or negative HIV status, and for HIV positive mothers who chose to breastfeed," wrote the authors.

The researchers asked 1,996 mothers who enrolled after the program began to complete a questionnaire assessing HIV knowledge and exposure to the program.

"HIV knowledge improved with increasing exposure to the program," the report stated. "Mothers who enrolled when the program was being fully implemented were 70 percent more likely to learn their HIV status early ("Formative research aided in the design of a culturally sensitive intervention," Piwoz and colleagues wrote. "The intervention increased relevant knowledge and improved feeding practices among women who primarily did not know their HIV status."

The study, "An Education and Counseling Program for Preventing Breast-Feeding-Associated HIV Transmission in Zimbabwe: Design and Impact on Maternal Knowledge and Behavior," appeared in the Journal of Nutrition (2005;135(4):950-955).

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