Crochet S, Desclaux A; International Conference on AIDS (15th : 2004 : Bangkok, Thailand).
Int Conf AIDS. 2004 Jul 11-16; 15: abstract no. ThPeE7948.
CRECSS/LEHA/MMSH (University), Aix en Provence, France
Background: Guide-lines have been set up to help HIV positive mothers make an "informed choice" about a feeding method for their new-born. As any public health measure, the concept of "informed choice" is a social construct. On the field, recommendations are shaped by the different actors' and institutions' ideas, political will and means at their disposal to enforce them. This research aims at exploring how institutional agency frame women's choices. Methods: Semi-structured in-depth interviews with forty eight HIV positive mothers; ethnographic procedures. Results: Results of our research show that so far there is little room for a choice since either method (breast-feeding or milk substitutes) is attached to the institutions' modus operandi. The staff's sense and apportionment of risks is not free and in the context of an emotional issue, conformity with the establishment regulations will ensue. Hence, the axiom that presenting facts such as HIV transmission through breast-feeding or the risks attached to formula feeding can be done in an "objective way" becomes contentious. When looking at all the components included in the mothers' decision-making processes, local organization of the health system play a major role, outstanding the influence of cultural factors. Public or established institutions and person-centered NGOs promote different, sometimes opposite preventive measures. Conclusions: Questions and recommendations include: a call to policy-makers to review the principles and conditions of informed choice; a discussion about the role of NGOs in the field of PMTCT and ways to better coordinate private initiatives and national policies; the need to train and assess health staff performance about the psychological stress of feeding counseling.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Bottle Feeding
- Breast Feeding
- Cambodia
- Choice Behavior
- Counseling
- Decision Making
- Evaluation Studies
- Feeding Methods
- Female
- HIV Infections
- HIV Seropositivity
- Health
- Health Planning Guidelines
- Humans
- Mothers
- Organizations
- ethnology
Other ID:
UI: 102281710
From Meeting Abstracts