Hiv transmission risk perceptions and factors associated with traditional child care practices among hiv+ve mothers attending Jaramogi Oginga Odinga teaching and referral Hospital, Kenya

Abstract

Traditional child care practices of premastication, uvulectomy and false teeth extraction are widespread in Africa including Kenya, but are not well documented in Kisumu County. Despite these practices being potential routes of HIV transmission, it is not known whether HIV-infected mothers consider them risky practices in the context of HIV transmission, especially in areas like Kisumu County that has the second highest HIV prevalence in Kenya at 17.4%. The study sort to investigate HIV transmission risk perceptions and factors associated with traditional child care practices among HIV-infected mothers attending Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH), Kenya. Specific objectives were to determine prevalence of the practices, identify cultural and socio-demographic factors associated with the practices and to determine association between the practices and perception of risk of HIV transmission to the children. A mixed method cross-sectional study was done between July 2021 and January 2022. A consecutive sample of 216 mothers out of 245 were enrolled for quantitative interviews and 3 Focus Group Discussions (FGDs) of 7, 8 and 7 participants for qualitative interviews. A questionnaire was used to collect quantitative data and interviewer guide for qualitative data from FGDs. False teeth extraction was most prevalent practice at 21.8%, uvulectomy at 14.9%, and premastication at 8.8%. Participants aged 24-28yrs were 59% less likely to practices the methods compared to those aged 19-23 years (OR=0.41, P=0.022). Mothers with post-secondary education were 61% less likely to practice these methods compared to those reporting primary level of education (OR= 0.39, P=0.049). Widowed or separated mothers had nearly 3-fold risk of practicing these methods compared to singles (OR=2.96, P = 0.049); whereas participants reporting being afraid of missing next meal were 2.4 times likely to practice these methods compared to those not afraid of missing next meal (OR= 2.41, P <0.001). Majority (71.3%) of participants were aware about risk of transmitting HIV through these practices. Paradoxically, proportion of mothers engaging in the practices was lower among those who said the risk of HIV-transmission through traditional practices was low compared to those who said the risk was high (PR=0.93, P=0.033). Proportion of mothers who engage in traditional practices was more than 4-fold among those who don‘t know if afraid of their babies getting HIV infection through traditional practices compared to those were afraid (PR=4.27, P<0.001). Results show that HIV-infected mothers are engaging in risky traditional practices. Continuous sensitization on these risky practices is necessary among HIV-infected mothers to discourage the practices.