Technologies of hope? Motherhood, HIV and infant feeding in eastern Africa.

A vast number of HIV positive mothers live with a known HIV positive status without an experienced ability to prevent the virus from spreading to their offspring. This article focuses on the dramatic effects on identity and sociality instigated by prevention of mother to child transmission of HIV (PMTCT) programmes, and discusses the potential for the development of HIV related activism linked to programme enrolment. Paying particular attention to the infant feeding options that are promoted through the programme - exclusive breastfeeding and replacement feeding - the article explores women's experiences struggling to secure an HIV free baby. At the heart of the findings lie devastating transformations in perceptions of body and self among HIV positive mothers enrolled in the PMTCT programmes, transformations highlighted by the shifting interpretations of mother's milk. The women suffer from extreme fear of feeding their babies HIV infected mother's milk. Very few mothers could afford formula products, and exclusive breastfeeding emerged as the option of the poor 'who have to breastfeed and let their babies die'. From being a prime symbol of nurture and love, mother's milk became a source of death in babies born to HIV positive mothers. The article argues that the incongruity between notions of maternal love and nurture on the one hand, and sexuality, HIV and death on the other, makes the PMTCT programme ill suited as a basis for activism. The material was collected through interviews and discussion with HIV positive mothers and nurse counsellors in Ethiopia and Tanzania, 2004-2006.