Women's Experiences of Infant Feeding Practices While Living With HIV in Malaysia: A Community-Based Qualitative Study

Background: With the advancement of antiretroviral therapy scale-up, it is possible for women living with HIV to breastfeed safely. However, this practice has not been adopted in Malaysia. Instead, infants are provided with subsidized human milk substitutes for their first 2 years of life. Research Aim: This study describes the infant feeding experiences of women living with HIV in Malaysia. Methods: From August to October 2021, a nationwide, community-based qualitative study was conducted among women living with HIV and who received care from the Malaysian Ministry of Health. Using purposive sampling, participants who met the inclusion criteria were recruited. Interview and focus group transcripts were coded based on a secondary thematic analysis. Results: Six in-depth interviews and five focus group discussions were conducted among 32 participants. Study participants were mostly Malay secondary school graduates in their 30s and 40s. Due to the fear of vertical transmission, which was explained by healthcare providers to the participants, none of the women breastfed their infants. The three primary themes that emerged from analyzing the women's infant feeding experiences were (1) a human milk substitute was the only option and was encouraged; (2) feeding infants with a human milk substitute made the women feel incomplete as mothers; and (3) the women encountered difficulties in obtaining the subsidized human milk substitute. Conclusion: Women living with HIV in Malaysia have been advised to provide human milk substitutes to their infants in fear of HIV transmission.

Automated summary

HIV-positive women in Malaysia are not encouraged to breastfeed and are instead provided with subsidized human milk substitutes. This practice leads to feelings of inadequacy as mothers and difficulties in obtaining the subsidized milk substitutes.