Exploring the complexities of infant feeding decisions for immigrant pregnant people living with HIV in Ontario, Canada: a qualitative study
Bibliographic record
Abstract
North American societies recommend that Pregnant People Living with Human Immunodeficiency Virus (PLWHIV) use formula to feed their infants to eliminate the risk of perinatal HIV transmission. However, many Canadian PLWHIV have migrated from HIV-endemic countries, where the World Health Organization recommends exclusive breastfeeding. These opposing recommendations, along with the complex interplay of social, cultural, and personal factors, create tension when making decisions regarding infant feeding. This study describes the experiences of PLWHIV in making decisions to inform healthcare providers and enhance guidelines for the use of breast milk. In-depth interviews were conducted with patients (n = 10) from a tertiary hospital in Toronto, Ontario. All participants were immigrants to Canada, with the majority (n = 8) self-identifying as African or Caribbean. Regarding their most recent pregnancy, 6 exclusively formula-fed, three exclusively used breast milk, and one used a combination of both feeding methods. The thematic analysis revealed four key themes: values and facilitators in the decision-making process, challenges experienced with infant feeding choices, reflections on these decisions, and recommendations for enhanced care. The findings highlight the need for socially and culturally inclusive evidence-based counseling, a safe environment, multidisciplinary care, and access to information that supports the best possible outcomes for both mothers and babies through informed decision-making.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.015 | 0.008 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".