“我们共同决定”：一项关于 HIV 感染女性与孩子父亲共同决策母乳喂养的定性研究。
"We decided together": a qualitative study about women with HIV navigating infant-feeding decisions with the father of their children.
机构信息
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Institute for Global Health, University College London, London, UK.
出版信息
BMC Pregnancy Childbirth. 2024 Jan 6;24(1):41. doi: 10.1186/s12884-023-06198-w.
BACKGROUND
The World Health Organization (WHO) recommends that women with HIV breastfeed for a minimum of one year. In contrast, United Kingdom (UK) guidelines encourage formula feeding, but breastfeeding can be supported under certain circumstances. Infant-feeding decisions often involve personal and social networks. Currently, little research addresses how individuals with HIV in high-income countries navigate infant-feeding decisions with the father of their children.
METHODS
Semi-structured remote interviews were conducted with UK-based individuals with a confirmed HIV positive diagnosis who were pregnant or one-year postpartum, and two partners. Using purposive sampling, pregnant and postpartum participants were recruited through HIV NHS clinics and community-based organisations, and where possible, fathers were recruited via them. Data were analysed using thematic analysis and organised using NVivo 12.
RESULTS
Of the 36 women interviewed, 28 were postpartum. The majority were of Black African descent (n = 22) and born outside the UK. The key factors in women navigating HIV and infant-feeding discussions with respect to their baby's father were the latter's: (1) awareness of woman's HIV status; (2) relationship with the woman; (3) confidence in infant-feeding decision; (4) support and opinion about woman's infant-feeding intentions. Most women made a joint decision with biological fathers when in a long-term (> one year) relationship with them. Single women tended not to discuss their infant-feeding decision with the father of their child, often for safety reasons.
CONCLUSION
Women in ongoing relationships with the father of their child valued their support and opinions regarding infant-feeding. In contrast, single women chose not to involve the father for reasons of privacy and safety. Clinical teams and community-based organisations should support mothers in discussing infant-feeding decisions regardless of relationship status. When appropriate, they should also support discussions with their partners, but remain sensitive to circumstances where this may put women at risk.
背景
世界卫生组织（WHO）建议感染艾滋病毒的妇女至少母乳喂养一年。相比之下，英国（UK）的指南鼓励配方奶喂养，但在某些情况下可以支持母乳喂养。婴儿喂养决策通常涉及个人和社交网络。目前，很少有研究探讨高收入国家的艾滋病毒感染者如何在与孩子父亲的情况下做出婴儿喂养决策。
方法
对英国的确诊 HIV 阳性孕妇或产后一年的妇女及其两名伴侣进行了半结构化远程访谈。通过有针对性的抽样，通过 NHS 艾滋病毒诊所和社区组织招募孕妇和产后参与者，并尽可能通过他们招募父亲。使用 NVivo 12 对数据进行主题分析和组织。
结果
在接受采访的 36 名妇女中，有 28 名是产后妇女。大多数是非洲裔黑人（n=22），并在英国出生。女性在与婴儿父亲就 HIV 和婴儿喂养问题进行讨论时考虑的关键因素是后者：（1）对女性 HIV 状况的认识；（2）与女性的关系；（3）对婴儿喂养决策的信心；（4）对女性婴儿喂养意图的支持和意见。当与亲生父亲处于长期（>一年）关系时，大多数妇女与亲生父亲共同做出婴儿喂养决策。单身女性往往出于安全原因，不会与孩子的生父讨论婴儿喂养决定。
结论
与孩子生父关系持续的女性重视他们对婴儿喂养的支持和意见。相比之下，单身女性出于隐私和安全原因选择不涉及父亲。临床团队和社区组织应支持母亲讨论婴儿喂养决策，无论其关系状况如何。在适当的情况下，他们还应支持与伴侣的讨论，但要对可能使妇女处于危险之中的情况保持敏感。
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