Male Partners' Roles in Infant Feeding Practices: Perspectives of Black Mothers Living with HIV in Three Countries.

Currently, mothers living with HIV (LWH) are challenged with different infant feeding guidelines depending on the country they are living in. This may contribute to confusion, stress, and mental health issues related to decision-making about infant feeding as a mother LWH. Yet, their male partners as their closest social capital have important roles to play in reducing or aggravating this psychosocial distress. Hence, we describe the role of male partners in supporting mothers who are living with HIV in the context of infant feeding. It is based on the results of a recent study of the socio-cultural context of infant feeding among Black mothers LWH in three countries; Canada, the USA, and Nigeria. The study was a tri-national, mixed-methods, community-based participatory research (CBPR) project, informed by postcolonialism and intersectionality theories. This paper is based on the qualitative component of the study. It was a focused ethnography (FE) involving 61 in-depth individual interviews (IDIs) with Black- mothers LWH. Thematic analysis guided the interpretation of these data, and trustworthiness was established through member-checking. Black mothers LWH acknowledged the various support roles that their male partners play in easing the practical and emotional burdens of infant feeding in the context of HIV. Male partners' roles were captured under three sub-themes: (1) Practical help, (2) Protection of the family, and (3) Emotional support and sounding board. These findings have explicated the evolving ways in which male partners support ACB mothers LWH to promote positive infant feeding outcomes, as well as enhance the emotional and physical well-being of both mother and infant. Our study has explicated the evolving ways in which male partners support Black mothers LWH to promote positive infant feeding outcomes, as well as enhance the emotional and physical well-being of both mother and infant.

Global Food Insecurity and African, Caribbean, and Black (ACB) Populations During the COVID-19 Pandemic: a Rapid Review.

BACKGROUND: The global food insecurity reinforces the ongoing impact of COVID-19 on human health and mortality. Although literature remained sparse, reports indicated that food insecurity is disproportionately high among African, Caribbean, and Black (ACB) population since the outset of COVID-19. Hence, we assessed the food insecurity conditions of ACB populations globally during the COVID-19 pandemic. METHODS: Comprehensive searches in CINAHL, Medline (Ovid), PubMed (Medline), Food Science and Technology Abstracts, SCOPUS, EMBASE, AMED, CAB Abstracts, Cochrane Library (OVID), and PsycINFO were carried out. Title/abstract and full-text screening, quality appraisal (modified JBI QARI), and data extraction were carried out by double reviewers. RESULTS: The initial search yielded 354 articles. After removal of duplicates and irrelevant articles, a full-text review and critical appraisal, 9 papers were included in the study. After data extraction and synthesis, six major themes emerged from the analysis: increased food insecurity, adverse health outcomes of food insecurity, exacerbation of existing disparities, systemic inequities and adverse policies, racism, and sociocultural response and solutions. CONCLUSION/IMPLICATIONS: The study showed that COVID-19 had exacerbated food insecurity and other health disparities within racialized populations including ACB people, due to systemic anti-Black racism; inadequate representation in decision-making; and issues of cultural appropriateness and competency of health services. While sociocultural response by ACB people through the expansion of their social capital is imperative, specific policies easing access to food, medicine, and shelter for racialized communities will ensure equity while reducing global food insecurity and health crises during the COVID-19 pandemic.

Psychosocial Experiences of HIV-Positive Women of African Descent in the Cultural Context of Infant Feeding: A Three-Country Comparative Analyses.

Infant feeding among mothers of African descent living with Human Immunodeficiency Virus (HIV) is a critical practice that is influenced by policies, cultural expectations, and the resultant psychosocial state of the mother. Hence, this paper draws insights from a broader infant feeding study. It provides insights into how guidelines on infant feeding practices, cultural expectations, migration, or geographic status intersect to influence the psychosocial experiences of mothers living with HIV. We compared psychosocial experiences of Black mothers of African descent living with HIV in Nigeria versus those in high-income countries (Canada and USA), in the context of contrasting national infant feeding guidelines, cultural beliefs about breastfeeding, and geographic locations. Survey was conducted in venue-based convenience samples in two comparative groups: (Ottawa, Canada and Miami-FL, USA combined [n = 290]), and (Port Harcourt, Nigeria [n = 400]). Using independent samples t-statistics, we compared the means and distributions of six psychosocial attributes between Black mothers in two distinct: Infant feeding groups (IFGs), cultural, and geographical contexts at p < 0.05. Psychosocial attributes, such as discrimination and stigma, were greater in women who exclusively formula feed (EFF) than in women who exclusively breastfeed (EBF) at p < 0.01. Heightened vigilance, discrimination, and stigma scores were greater in women whose infant feeding practices were informed by cultural beliefs (CBs) compared to those not informed by CBs at p < 0.001. Discrimination and stigma scores were greater among mothers in Canada and the USA than in Nigeria at p < 0.001. Heightened vigilance and perceived stress scores were less among women in Canada and the USA than in Nigeria at p < 0.001. The guidelines on infant feeding practices for mothers with HIV should consider cultural expectations and migration/locational status of mothers.

Social Determinants of Breastfeeding Preferences among Black Mothers Living with HIV in Two North American Cities.

The study is motivated by the need to understand the social determinants of breastfeeding attitudes among HIV-positive African, Caribbean, and Black (ACB) mothers. To address the central issue identified in this study, analysis was conducted with datasets from two North American cities, where unique country-specific guidelines complicate infant feeding discourse, decisions, and practices for HIV-positive mothers. These national infant feeding guidelines in Canada and the US present a source of conflict and tension for ACB mothers as they try to navigate the spaces between contradictory cultural expectations and national guidelines. Analyses in this paper were drawn from a broader mixed methods study guided by a community-based participatory research (CBPR) approach to examine infant feeding practices among HIV-positive Black mothers in three countries. The survey were distributed through Qualtrics and SPSS was used for data cleaning and analysis. Results revealed a direct correlation between social determinants and breastfeeding attitude. Country of residence, relatives' opinion, healthcare providers' advice and HIV-related stigma had statistically significant association with breastfeeding attitude. While the two countries' guidelines, which recommend exclusive formula feeding, are cardinal in preventing vertical transmission, they can also be a source of stress. We recommend due consideration of the cultural contexts of women's lives in infant feeding guidelines, to ensure inclusion of diverse women.