Breastfeeding continues to pose a significant risk of HIV transmission to infants born to HIV-infected mothers, accounting for 200,000 infants sero-converting per year in low-resource settings. Myriad social, cultural and economic factors, including knowledge of HIV/AIDS and HIV status, could affect the extent to which women adhere to the recommended practice of exclusive breastfeeding after delivery. Very little research has examined the effects of knowledge of HIV/AIDS and HIV testing status on infant feeding intentions in the antenatal period and followed women to ascertain actual practices postnatally. To address these gaps in the literature, Dr. Onono will examine the effects of HIV/AIDS knowledge, attitudes and testing status on infant feeding intentions before birth and actual postnatal practices in a cohort of pregnant women; including those who are HIV-positive, HIV-negative, and those of unknown HIV status. Beginning in 2007, the KEMRI-UCSF Collaborative Group working with Family AIDS Care and Education Services (FACES) began a prospective study entitled "The Maternity in Migori and AIDS Stigma Study" (The MAMAS Study) to examine the effects of HIV/AIDS stigma on the utilization of non-HIV related health services. The research plan described in this proposal will be nested within the larger MAMAS Study (N=943). Data are being collected from a cohort of pregnant women who attend 10 antenatal care (ANC) clinics in Migori and Rongo Districts of Western Kenya. During the proposed training period, Dr. Onono will work with Dr. Turan the PI for the MAMAS Study and Dr. Bukusi her co-mentor to supervise data collection and management, conduct the analyses regarding infant feeding, and prepare manuscripts stemming from the investigation. Her support from this grant and the time spent at UCSF will enhance Dr. Onono's clinical research expertise, including analytical and scientific writing skills, and will lead to the design of future studies to be conducted at the KEMRI-UCSF Program research sites in Kenya.