Determinants of Infant Feeding Practice Among HIV-Postitive Mothers in Ethiopia

描述（由申请人提供）：与其他高流行国家相比，埃塞俄比亚近年来在艾滋病发病率方面取得了显著的下降。然而，联邦卫生部认识到，对艾滋病毒母婴传播的预防不足（通常是通过不理想的婴儿喂养做法）阻碍了这一努力。虽然已经确定了一种关键但未充分利用的积极喂养做法，即纯母乳喂养（EBF）的一些相关因素，但可能阐明因果关系的中介因素在很大程度上仍然未知。本研究将运用计划行为理论来研究影响妇女哺育婴儿决策和行为的因素，以便设计和实施有效的健康干预措施。本研究的目的是：1)开发并验证一份基于TPB的文化相关调查问卷，重点关注亚的斯亚贝巴艾滋病毒阳性母亲的EBF；2)评估TPB对出生时和产后3个月EBF行为意向和实际行为的解释能力；3)识别影响EBF行为意愿强度和稳定性的变量。目标人群是埃塞俄比亚艾滋病毒感染率最高的亚的斯亚贝巴的艾滋病毒阳性孕妇和产后妇女。采用有目的抽样方法，将从亚的斯亚贝巴的4家医院招募168名患者。第一个目标将通过进行定性访谈来解决，以在目标人群中引出与EBF实践相关的显著行为，规范和控制信念。结果将用于制定和验证与文化相关的调查问卷，以便定量测量

DESCRIPTION (provided by applicant): Compared to other high-prevalence countries, Ethiopia has achieved a remarkable reduction in HIV incidence in recent years. However, the Federal Ministry of Health recognizes that inadequate prevention of mother-to- child transmission of HIV, often through suboptimal infant feeding practices, has hindered this effort. While some correlates of a key but underutilized positive feeding practice, exclusive breastfeeding (EBF), have been identified, the mediating factors that might elucidate causal relationships remain largely unknown. This study will use the Theory of Planned Behavior to examine the factors that underlie women's infant feeding decision- making and behavior, so that effective health interventions can be designed and implemented. The aims of this study are: 1) to develop and validate a culturally relevant survey questionnaire, based on the TPB, focusing on EBF among HIV-positive mothers in Addis Ababa; 2) to assess the ability of the TPB to explain EBF behavioral intention and actual behavior at time of birth and three months postpartum; and 3) to identify variables that modify the strength and stability of EBF behavioral intention. The target population is HIV-positive pregnant and postpartum women in Addis Ababa, where HIV prevalence is highest in Ethiopia. Using a purposive sampling methodology, 168 patients will be recruited from 4 hospitals in Addis Ababa. The first aim will be addressed by conducting qualitative interviews to elicit salient behavioral, normative, and control beliefs related to EBF practice among the target population. Results will be used to develop and validate a culturally relevant survey questionnaire that will allow for quantitative measurement of causal relationships between TPB constructs over time. The second and third aim will be addressed by administering this quantitative survey to a prospective cohort of HIV positive women at time of birth and 3 months postpartum. The survey will collect data on demographic and socioeconomic character, utilize Likert scales (based on formative research) to measure attitudes, social norms, perceived behavioral control, and behavioral intention, and determine actual infant feeding behavior. Data will be analyzed using Structural Equation Modeling (SEM), a technique similar to regression modeling that allows multiple independent and dependent variables to be analyzed simultaneously.