The objective of this study was to assess complementary feeding practices and associated factors among HIV exposed
infants in Sidama Zone, Southern Ethiopia. An institutional based cross-sectional study with cluster random sampling
technique was employed and all HIV exposed infants aged 6-17 months found in randomly selected health institutions
in Sidama zone, Southern Ethiopia were included. A 24-hour dietary recall and 7-day quasi-food group frequency was
used to assess complementary feeding practices. The prevalence of timely initiation of complementary feeding (6-8
months) was 42% [95% CI: (30-54%)]. Of all the HIV exposed infants aged 6-17 months, 40.7% had practiced bottlefeeding.
About 65.6% and 53.3% of HIV exposed infants did not receive the recommended number of food groups and
frequency of complementary feeding in the last 24 hours respectively. Pulse (plant protein) was consumed by only
22.5% of the infants while only 9.9% of the infants consumed animal source food in the last 24 hours. Presence of
infant food prohibition (ß = -0.342, P = 0.001) and age of the infant (ß = 0.311, P = 0.001) were found to be an
independent predictors of dietary diversity. Presence of infant food prohibition (ß = -0.181, P = 0.02) and age of infant
(ß = 0.388, P < 0.001) were also the predictors of 24 hour meal frequency. Having lower educational status [AOR = (0.21,
95% CI (0.062-0.71)] was an independent negative predictor of bottle-feeding practice. Many of the complementary
feeding practices like meal frequency; dietary diversity and bottle-feeding were sub-optimal. Nutrition education should
be designed for improving complementary feeding practices of HIV exposed infants in Sidama Zone, Southern
Ethiopia. Mothers with higher educational status should be also targeted for nutrition education especially on bottle
feeding practice.