Background Exclusive breastfeeding (EBF) for 6 months is ranked as the most effective way of feeding babies in Sub-Saharan Africa where HIV positive women are poor and infant mortality is high. However, mixed feeding is common, increasing risks of infant death due to malnutrition, diarrhoeal, HIV, and other infectious diseases. Community-based Interventions has proved effective in promoting EBF in poor settings. Results of MaiMwana intervention in Malawi are underway. However, there was little attention on the needs of HIV positive women during the design and conduct of these interventions. The aim of this study was to explore the importance and experiences with implementing the intervention in Mchinji, Malawi in the context of HIV.

Method We purposively selected and conducted qualitative in-depth interviews with 39 key informants in Mchinji, Malawi between January to August 2012 using a pre-designed interview guide. Responses were analysed by Framework analysis. The study was approved by the Malawi National Health Sciences and City University London research ethics committees.

Results HIV positive and negative women were supportive of the intervention for continuity of infant feeding counselling as volunteers spend more time with them. HIV positive women appreciated the visit because they had to tell their storey to someone. However, some did not disclose their status due to fear of stigma and abandonment by family members present during the visit, making it difficult for counsellors to effectively provide counselling on EBF. Service users also find the intervention as not being cost-effective due to lack of time and money to travel to the hospital for other health services.

Conclusion It is important for projects to consider the needs of HIV positive women when designing community-based interventions to reduce HIV transmission and deaths among infants. Integration of services is desired considering the levels of poverty and distance to health facilities.