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You, Me & HIV - Kenya

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Story context

Kenya has expanded access to prevention of mother to child transmission (PMTCT) services so that more mothers like Mary can have children who are born HIV free. HIV can be transmitted from mother to child during pregnancy, birth, or via breastfeeding. In the case of Mary, antiretroviral treatment (ART) meant that her child was born HIV free, but there is still every chance that she can transmit HIV to her child whilst breastfeeding – the safest way to eliminate this risk is through formula feeding.

In many low resource settings however, this is not possible – because of a lack of access to clean water; the high costs of formula feed; and lack of access to comprehensive healthcare services, for example. In these cases, the World Health Organisation (WHO) will issue different guidelines for feeding infants. 1 Mary, however, is lucky to have access to these services, and has been advised by her doctor to formula feed.

Whilst Mary’s doctor has recommended formula feeding, breastfeeding at least in part, is the cultural norm. In areas where people live more traditional lifestyles, formula feeding can be seen as wrong, and mothers who choose to do this are considered to be bad mothers. Chenge worries about the pressure and social stigma that Mary feels from her in-laws and the wider community. There is also the added issue that the community might assume that Mary is living with HIV, because she is bottle feeding.

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