“Go With the Flow:” A Qualitative Description of Infant Feeding Experiences Among Women With HIV in the United States

Pagano-Therrien, Jesica; Griswold, Michele K.; Amoah, Rita K.

doi:10.1097/jnc.0000000000000411

Cited by 2 publications

(1 citation statement)

References 51 publications

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“…Recently, guidance has changed to a more nuanced approach, following risk stratification with women on suppressive ART being supported to breastfeed [ 6 – 8 , 29 , 30 ]. However, gaps in knowledge of women's experiences, beliefs and desires and effective risk-counselling around infant feeding remain [ 31 ].…”

Section: Policies and Clinical Studies In High-income Countriesmentioning

confidence: 99%

Infant feeding: emerging concepts to prevent HIV transmission

Bamford,

Foster,

Lyall

2023

Current Opinion in Infectious Diseases

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Purpose of review HIV screening in pregnancy, universal suppressive antiretroviral therapy (ART) and breastfeeding avoidance can almost completely prevent vertical transmission of HIV. Breastfeeding is associated with an additional risk of transmission, although this risk is extremely low with suppressive maternal ART. This minimal risk must be balanced with the benefits of breastfeeding for women living with HIV (WLHIV) and their infants. Guidance in high-income countries has evolved, moving towards supported breast feeding for women on suppressive ART. Recent findings Breastmilk transmission accounts for an increasing proportion of new infant infections globally. The majority of transmission data comes from studies including women not on suppressive ART. Breastmilk transmissions in the context of undetectable viral load have rarely occurred, although risk factors remain unclear. Outcome data on supported breastfeeding are accumulating, providing evidence for guidelines and informing infant feeding decisions. Long-acting ART for maternal preexposure prophylaxis or treatment, and infant postnatal prophylaxis are promising future options. Summary Breastfeeding on suppressive ART has a very low risk of vertical transmission and can have multiple benefits for WLHIV and their infants. However, caution is advised with relaxation of breastfeeding guidance so as not to jeopardise the global goal of elimination of vertical transmission by 2030.

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Section: Policies and Clinical Studies In High-income Countriesmentioning

confidence: 99%

Infant feeding: emerging concepts to prevent HIV transmission

Bamford,

Foster,

Lyall

2023

Current Opinion in Infectious Diseases

View full text Add to dashboard Cite

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Perception and Emotional Experiences of Infant Feeding Among Women Living With HIV in a High-Income Setting: A Longitudinal Mixed Methods Study

Moseholm,

Fetters,

Aho

et al. 2024

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: The recommendation of breastfeeding avoidance for women living with HIV in high-income settings may be influenced by cultural beliefs and come at an emotional cost. This multi-center, longitudinal, convergent mixed methods study aimed to compare differences in attitudes, concerns and experiences surrounding breastfeeding in women living with HIV of Nordic and non-Nordic origin. Setting: High-income setting Methods: Pregnant women living with HIV in the Nordic countries Denmark, Finland, and Sweden were recruited in 2019–2020. Quantitative data on attitudes surrounding infant feeding was assessed using the Positive Attitudes Concerning Infant Feeding (PACIFY) questionnaire completed in the third trimester (T1), and 3 (T2) and 6 (T3) months postpartum. Women who completed the survey were also invited to participate in semi-structured interviews at T1 and T3. Findings from the quantitative survey and qualitative interviews were brought together through merging to assess for concordance, complementarity, expansion, or discordance between the datasets, and to draw meta-inferences. Results: In total, 44 women completed the survey, of whom 31 also participated in qualitative interviews. The merged analyses identified three overarching domains representing commonalities across the quantitative and qualitative data: emotional impact, justifying not breastfeeding, and coping strategies. Not being able to breastfeed was emotionally challenging. Cultural expectations influenced the women’s experiences and the strategies they used to justify their infant feeding choice. Conclusion: For women living with HIV in Nordic countries not breastfeeding was a complex, multi-layered process substantially influenced by social and cultural expectations.

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“Go With the Flow:” A Qualitative Description of Infant Feeding Experiences Among Women With HIV in the United States

Cited by 2 publications

References 51 publications

Infant feeding: emerging concepts to prevent HIV transmission

Infant feeding: emerging concepts to prevent HIV transmission

Perception and Emotional Experiences of Infant Feeding Among Women Living With HIV in a High-Income Setting: A Longitudinal Mixed Methods Study

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