Background: Despite the existence of evidence-based HIV-exposed infant feeding guidelines,
infants in Africa still acquire HIV through inappropriate feeding practices.
Objective: To identify predictors of HIV-exposed infant feeding knowledge and counseling practice
among health care workers (HCW) in Nigeria.
Methods: Structured, pretested questionnaires were administered to HCW (n=262) in a tertiary
health facility in Kano, Nigeria. Multivariate logistic regression was used to determine predictors of
HIV-exposed infant feeding knowledge and counseling practice.
Results: Of 262 respondents, (58.0%, n=152) had good knowledge of recommended feeding options.
Respondents listed exclusive breastfeeding (57.6%, n=151), human milk substitutes (45.4%,
n=119), HIV-negative wet-nursing (37.0%, n=97), heated expressed human milk (20.6%, n=54) and
mixed feeding (13.4%, n=35) as appropriate feeding choices. Over half (57.3%, n=150) of the respondents
have ever counseled a HIV-positive mother on infant feeding. Knowledge was predicted
by female sex (Adjusted Odds Ratio (AOR)=2.47, 95% Confidence Interval (CI):1.35-4.52), profession
(physician vs. laboratory scientist, AOR=4.00, 95%CI:1.25-12.87; nurse/midwife vs. laboratory
scientist, AOR=2.75, 95%CI:1.17-9.28), infant feeding counseling training (AOR=3.27,
95%CI:1.87-5.71), and number of children (2-4 vs. 0, AOR=1.75, 95%CI:1.23-3.92). Infant feeding
counseling was predicted by female sex (AOR=2.85, 95%CI:1.39-5.85), age (>40 vs. <30 years,
AOR=3.87, 95%CI:1.27-15.65), knowledge of infant feeding options (good vs. fair/poor,
AOR=3.96, 95%CI:2.07-7.59), training (AOR=2.60, 95%CI:1.42-5.32), and profession (physician
vs. laboratory scientist, AOR=10.7, 95%CI:2.85-40.54; nurse/midwife vs. laboratory scientist,
Conclusion: The practice of infant feeding counseling among HCW in Nigeria is associated with
sex, knowledge, and profession. Our findings may inform the development of targeted training programs
for HCW in similar settings.