Acceptability of a nipple shield delivery system administering antiviral agents to prevent mother-to-child transmission of HIV through breastfeeding

In order to improve access to maternal health, one potential innovation recommendation is the use of a nipple shield delivery system (NSDS) to administer antiviral agents for preventing mother-to-child transmission of HIV through breastfeeding. The NSDS is being developed as an accessible method to deliver antiretroviral (ARV) prophylaxis to infants, addressing hygiene and storage issues in low-resource settings.


1. Study Design: Conduct a mixed-methods study involving focus group discussions and in-depth interviews to gather data on the acceptability, safety, and efficacy of the NSDS for preventing mother-to-child transmission of HIV during breastfeeding.

2. Participant Selection: Recruit HIV-positive mothers, grandmothers/mothers-in-law, fathers/husbands, and maternal/child health care providers from diverse backgrounds and regions in Kenya to ensure a representative sample.

3. Data Collection: Conduct eleven focus group discussions, each consisting of 7 to 12 participants, to explore participants’ understanding of mother-to-child transmission of HIV, assess their acceptance of the NSDS, and identify cultural and implementation issues that may affect its acceptability. Additionally, conduct ten in-depth interviews with individual maternal/child health care providers to gather their perspectives on the NSDS.

4. Discussion Topics: Cover a range of topics in the focus group discussions and interviews, including infant feeding and HIV stigma, safety, effectiveness, and feasibility of the NSDS. Use device prototypes during the discussions to facilitate understanding and feedback.

5. Data Analysis: Analyze the qualitative data collected from the focus group discussions and interviews using thematic analysis to identify common themes, patterns, and insights related to the acceptability of the NSDS.

6. Recommendations and Strategies: Based on the findings, develop recommendations and strategies to address HIV-related stigma, access, efficacy, and hygiene concerns associated with the NSDS. These recommendations should aim to minimize stigma and ensure continuous hygiene of the device.

7. Further Studies: Acknowledge the need for further studies to confirm the acceptability, safety, and efficacy of the NSDS. Consider conducting larger-scale trials or pilot programs to assess the real-world impact of implementing the NSDS for preventing mother-to-child transmission of HIV during breastfeeding.

By following this methodology, researchers can gain valuable insights into the acceptability of the NSDS and develop strategies to improve access to maternal health by addressing the identified barriers and concerns.