determine associations between the preferred feeding choices and the factors affecting the decisions.Results: The findings revealed good knowledge (60%) of the infant feeding options among the respondents. About 42.9% of the women felt the counsellors were not convinced to certain limit which method was best, hence they not confidently guide them on the correct options. The adoption of infant feeding options as recommended by WHO was not optimal. Reasons included deterrents like financial limitations in 36.9% of respondents which was statistically significant at the bivariate (p= <0.001) and multivariate (p=0.013, odds ratio = 32.779) levels. This showed that respondents with financial constraints were 32 times less likely to practice the ideal feeding options than women who are not financially constrained. Also, sociocultural norms and beliefs in 40%, and the knowledge of risks associated with some feeding practices (38.5%) statistically significant (p=0.022 and 0.023 at bivariate and multivariate levels respectively). In the course of feeding their children, the respondents had challenges of insufficient breast milk, stigma and discrimination, among others.Conclusion: High proportions of respondents know the recommended infant feeding options, though the adoption of, and adherence to the ideal methods is not practiced. Sociocultural norms, fear of stigma, discrimination, and financial constraints affect their ability to do so. It is recommended that effective counselling services should be made available to HIV positive women in the hospital by trained hospital personnel to guide such women on making correct choices.