{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T07:56:24Z","timestamp":1791186984332,"version":"4.1.0"},"reference-count":61,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>Exclusive breastfeeding (EBF) reduces infant mortality and HIV vertical transmission (VT). The 2016 World Health Organisation (WHO) guidelines recommend 6 months of EBF for mothers living with HIV (MLWH) on antiretroviral therapy, yet uptake in sub\u2010Saharan Africa (SSA) remains low, and evidence on predictors is fragmented. This scoping review synthesised quantitative evidence on predictors of EBF among MLWH in SSA since the 2016 WHO guidelines, identifying geographic gaps and methodological trends to guide research and policy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following Joanna Briggs Institute methodology and PRISMA\u2010ScR reporting, five databases, PubMed, EMBASE, Web of Science, Scopus, and Global Health, were searched for studies conducted from 2016 onwards that quantitatively assessed predictors of EBF among MLWH in SSA. Included studies were descriptively synthesised and mapped by geography, frequency, association, and analysis type. Quality appraisal used the Mixed Methods Appraisal Tool 2018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>19 studies met inclusion criteria. Positive predictors included healthcare engagement, knowledge, favourable attitudes, and HIV\u2010status disclosure. Negative\/mixed predictors included employment, education, and pregnancy complications. Studies were geographically skewed (42% from Ethiopia), largely cross\u2010sectional (74%), and facility\u2010based. Psychosocial, socioeconomic, and biological\/clinical barriers remain underexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Evidence on EBF predictors among MLWH in SSA remains limited, geographically uneven, and methodologically restricted. Future research should adopt longitudinal, intervention\u2010focused, and contextually diverse designs to inform scalable, culturally responsive strategies for improving EBF and preventing HIV VT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.73170","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T07:52:50Z","timestamp":1788940370000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictors of Exclusive Breastfeeding Amongst Mothers Living With HIV in Sub\u2010Saharan Africa: A Scoping Review"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8921-9987","authenticated-orcid":false,"given":"Lydia","family":"Ives","sequence":"first","affiliation":[{"name":"Well Being Africa Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyi","family":"Ji","sequence":"additional","affiliation":[{"name":"Well Being Africa Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7211-0231","authenticated-orcid":false,"given":"Mojisola Deborah","family":"Kupolati","sequence":"additional","affiliation":[{"name":"Well Being Africa Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angel Macia","family":"Khoza","sequence":"additional","affiliation":[{"name":"Well Being Africa Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8271-8192","authenticated-orcid":false,"given":"Phumudzo","family":"Tshiambara","sequence":"additional","affiliation":[{"name":"Department of Human Nutrition, Faculty of Health Sciences University of Pretoria Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"e_1_2_12_2_1","volume-title":"HIV and AIDS. In StatPearls [Internet]","author":"Swinkels H. M.","year":"2025"},{"key":"e_1_2_12_3_1","unstructured":"UNAIDS. (2025).Global HIV & AIDS statistics \u2014 Fact sheet https:\/\/www.unaids.org\/en\/resources\/fact-sheet."},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000002487"},{"key":"e_1_2_12_5_1","unstructured":"World Health Organization. (2023).Exclusive Breastfeeding for Optimal Growth Development and Health of Infants https:\/\/www.who.int\/tools\/elena\/interventions\/exclusive-breastfeeding."},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13006-021-00366-4"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0081307"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1017\/S136898001000306X"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-018-2208-0"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60283-9"},{"key":"e_1_2_12_11_1","unstructured":"World Health Organization & United Nations Children's Fund. (2016).Guideline: Updates on HIV and Infant Feeding: The Duration of Breastfeeding and Support From Health Services to Improve Feeding Practices Among Mothers Living With HIV https:\/\/www.who.int\/publications\/i\/item\/9789241549707."},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/v15040849"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2019.00401"},{"key":"e_1_2_12_14_1","unstructured":"World Health Organization & United Nations Children's Fund. (2025).Global Nutrition Targets 2030: Breastfeeding Brief https:\/\/www.who.int\/publications\/i\/item\/B09382."},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nwh.2023.03.006"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-014145"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.5897\/JAHR2015.0353"},{"issue":"4","key":"e_1_2_12_18_1","first-page":"27","article-title":"Experiences of HIV\u2010Infected Mothers Regarding Exclusive Breastfeeding in the First Six Months of the Infant's Life in Mangaung, South Africa","volume":"23","author":"Phakisi S.","year":"2019","journal-title":"African Journal of Reproductive Health"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13006-017-0125-x"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu15061500"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0296593"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200102160-00011"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-021-01441-2"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13006-017-0109-x"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0224029"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12545"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13006-015-0052-7"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13006-019-0251-8"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-025-07188-w"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1080\/1364557032000119616"},{"key":"e_1_2_12_31_1","doi-asserted-by":"crossref","unstructured":"M.Peters C.Godfrey P.Mclnerney Z.Munn A.Tricco andH.Khalil(2024). Scoping reviews. In E. Aromataris C. Lockwood K. Porritt B. Pilla & Z. Jordan (Eds.) JBI Manual for Evidence Synthesis. JBI https:\/\/doi.org\/10.46658\/JBIMES-24-01.","DOI":"10.46658\/JBIMES-24-09"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/XEB.0000000000000277"},{"key":"e_1_2_12_33_1","unstructured":"World Bank. FOCUS: Sub\u2010Saharan Africa World Bank Group https:\/\/openknowledge.worldbank.org\/pages\/focus-sub-saharan-africa."},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.7326\/M18-0850"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.3233\/EFI-180221"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijans.2022.100485"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.curtheres.2019.100568"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-021-10675-2"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268822001091"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.2147\/HIV.S414636"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/7962054"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12981-022-00451-6"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13006-025-00716-6"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S343213"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13006-018-0181-x"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1080\/16549716.2020.1833510"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1177\/0890334419835171"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-019-4457-z"},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0210782"},{"key":"e_1_2_12_51_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0271167"},{"key":"e_1_2_12_52_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13006-017-0113-1"},{"key":"e_1_2_12_53_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13006-024-00693-2"},{"key":"e_1_2_12_54_1","unstructured":"United Nations Children's Fund. (2023).Global Breastfeeding Scorecard: Rates of Breastfeeding Increase Around the World Through Improved Protection and Support https:\/\/www.unicef.org\/media\/150586\/file\/Global%20breastfeeding%20scorecard%202023.pdf."},{"key":"e_1_2_12_55_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-031890"},{"key":"e_1_2_12_56_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13006-025-00744-2"},{"key":"e_1_2_12_57_1","volume-title":"The Health Belief Model of Behavior Change. In StatPearls [Internet]","author":"Alyafei A.","year":"2025"},{"key":"e_1_2_12_58_1","doi-asserted-by":"publisher","DOI":"10.4314\/ahs.v21i3.15"},{"key":"e_1_2_12_59_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.13740"},{"key":"e_1_2_12_60_1","unstructured":"World Health Organization & United Nations Children's Fund. (2021).Indicators for Assessing Infant and Young Child Feeding Practices: Definitions and Measurement Methods https:\/\/creativecommons.org\/licenses\/by-nc-sa\/3.0\/igo."},{"key":"e_1_2_12_61_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-019-7518-2"},{"key":"e_1_2_12_62_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-016-1557-9"}],"container-title":["Health Science Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.73170","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hsr2.73170","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.73170","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T07:44:49Z","timestamp":1791186289000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hsr2.73170"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":61,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/hsr2.73170"],"URL":"https:\/\/doi.org\/10.1002\/hsr2.73170","archive":["Portico"],"relation":{},"ISSN":["2398-8835","2398-8835"],"issn-type":[{"value":"2398-8835","type":"print"},{"value":"2398-8835","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-04-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e73170"}}