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Moving ahead
Internal grant gives life to infant feeding methods research team.
- If everything goes as planned, Special Research Initiation Grants (SPRIG)
at Iowa State allow campus researchers to begin their work or scholarship
and lead to future funding.
That's exactly what happened to Robert Mazur, associate professor of sociology,
and Grace Marquis, assistant professor of food science and human nutrition,
and their project, "Mother-to-Child Transmission of HIV Through Breastfeeding:
A Pilot Study on Attitudes, Beliefs, and Social Norms in Urban Ghana."
"The SPRIG enabled us to conduct initial focus group discussions that
served as the basis for developing the second phase and third phase components
of the comprehensive study," said Mazur. "The grant also helped
us move forward successfully with obtaining external funding."
In addition to the SPRIG and other campus funding sources, the Mazur and
Marquis research team has recently been awarded a five-year National Institute
of Health (NIH) grant for research and training. This project will also
involve researchers from the University of Connecticut, Emory University
and the University of Ghana.
The project looks at the increasing prevalence of mother-to-child transmission
(MTCT) of HIV via breastfeeding and the resulting decision HIV positive
mothers have to make in feeding their children.
Mazur says Ghana was picked for this study because just under five percent
of the adult population in that African country is estimated to have the
HIV virus, often considered the threshold for the epidemic to rapidly spread.
Some sections of Ghana have more than 13 percent, and countries in southern
Africa have close to a 40 percent HIV infection rate among adults.
"This is an area where we can have an impact," he said. "Elsewhere
in Africa the AIDS epidemic is totally out of control. Life expectancy of
55-60 years in the late 1990s could dip into the 30s by 2010."
The original SPRIG allowed Marquis and Mazur to send Yi-Kyoung Lee, a graduate
student in food science and human nutrition, to conduct field research in
Ghana. Data were collected in three phases including focus group discussions
with pregnant women and health care workers in the spring of 2002; in-person
interviews with 403 pregnant women from June-October 2002; and in-depth
follow-up interviews with 40 pregnant women from August 2002-January 2003.
The final group of women had indicated a risk of getting HIV or an intention
of having voluntary prenatal HIV testing.
"The preliminary analyses have shown that the majority of Ghanaian
pregnant women studied knew exclusive breastfeeding is recommended for six
months," Lee notes. "However, a little more than half intended
to exclusively breastfeed their child for the first six months; about one
in five participants intended to feed only breast milk for less than three
months."
National statistics, however, suggest that most of these women will not
carry out this intention; by three months over 70 percent were not exclusively
breastfeeding.
"Unfortunately 40 percent of Ghanaian mothers think if they have HIV
that there is nothing they can do that won't pass along HIV to their child
and another 14 percent didn't know how to curtail mother-to-child tranmission,"
Lee said.
Marquis says MTCT of HIV occurs three ways - during pregnancy, during the
delivery of the child, and/or during breastfeeding.
"However if transmission hasn't occurred at birth, research indicates
that if a mother exclusively breastfeeds her child then the chances of transmitting
the HIV virus dramatically decreases, compared to mixed feeding," Marquis
said. "And by exclusive breastfeeding, we even mean no water. Otherwise
the only real choice would be not to breastfeed at all and given the economic
conditions of most of these women, that’s almost impossible."
The next stage of the project is to look at the social aspects of the issue
including child care, alternative feeding methods, and the role that community
and the extended family should play in dealing with this issue.
"We believe their knowledge of HIV is increasing, but there still are
a lot of misconceptions when it comes to mother-to-child transmissions,"
Marquis said.
Robert Mazur, Yi-Kyoung Lee, Grace Marquis
Around LAS
March 24 to April 6, 2003
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