Paper short abstract:

PMTCT-guidelines in Lesotho follow the WHO recommendations, which don't fit neatly with traditional ideas regarding birthing, breastfeeding and weaning. My presentation looks on conflicting demands by providers and consumers of health care and how cultural implications impact on a clinical trial.

Paper long abstract:

From a biomedical point of view prevention of mother to child transmission of HIV (PMTCT) requests behavioural changes regarding birthing, breastfeeding and weaning. As a technological intervention PMTCT affects processes closely connected to traditional ideas about proper childcare, since attitudes towards early childcare imply both social and biological dimensions, which influence behaviour of health care providers and health care consumers.

The Lesotho PMTCT guidelines follow the WHO Guidelines for resource-constrained countries, which in most cases provide women with a short course ART-regimen. HIV exposed infants are treated additionally with a post partum short course exposition prophylaxis and mothers are advised to opt for either bottle-feeding or a short period of exclusive breast-feeding followed by fast weaning. In Lesotho, however, most HIV-positive women opt for the latter without any additional food or liquid given to the child, although long term mixed feeding with additional nutriments is culturally normative.

Apparently, technological interventions and advices given to the women during counselling sessions clash with cultural norms of early childcare and a high number of mothers lack compliance due to economic and socio-cultural conditions. My presentation looks on conflicting demands of providers and consumers of health care and how cultural implications impact on a clinical trial. The trial suggests a licensed regimen, which indicates comparable safety and efficacy to other PMTCT regimen and better adaptation to traditional concepts in Lesotho.