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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
High uptake of exclusive breastfeeding and reduced early post-natal HIV transmission
PLoS ONE, Volume 2, No. 12, Article e1363, Year 2007
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Description
Background. Empirical data showing the clear benefits of exclusive breastfeeding (EBF) for HIV prevention are needed to encourage implementation of lactation support programs for HIV-infected women in low resource settings among whom replacement feeding is unsafe. We conducted a prospective, observational study in Lusaka, Zambia, to test the hypothesis that EBF is associated with a lower risk of postnatal HIV transmission than non-EBF. Methods and Results. As part of a randomized trial of early weaning, 958 HIV-infected women and their infants were recruited and all were encouraged to breastfeed exclusively to 4 months. Single-dose nevirapine was provided to prevent transmission. Regular samples were collected from infants to 24 months of age and tested by PCR. Detailed measurements of actual feeding behaviors were collected to examine, in an observational analysis, associations between feeding practices and postnatal HIV transmission. Uptake of EBF was high with 84% of women reporting only EBF cumulatively to 4 months. Post-natal HIV transmission before 4 months was significantly lower (p = 0.004) among EBF (0.040 95% CI: 0.024-0.055) than non-EBF infants (0.102 95% CI: 0.047-0.157); time-dependent Relative Hazard (RH) of transmission due to non-EBF=3.48 (95% CI: 1.71-7.08). There were no significant differences in the severity of disease between EBF and non-EBF mothers and the association remained significant (RH = 2.68 95% CI: 1.28-5.62) after adjusting for maternal CD4 count, plasma viral load, syphilis screening results and low birth weight. Conclusions. Non-EBF more than doubles the risk of early postnatal HIV transmission. Programs to support EBF should be expanded universally in low resource settings. EBF is an affordable, feasible, acceptable, safe and sustainable practice that also reduces HIV transmission providing HIV-infected women with a means to protect their children's lives. © 2007 Kuhn et al.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC2137948/bin/pone.0001363.s001.doc
Authors & Co-Authors
Kuhn, Louise
United States, New York
Gertrude H. Sergievsky Center
Sinkala, Moses M.
Zambia, Lusaka
Lusaka District Health Management Team
Kankasa, Chipepo
Zambia, Lusaka
University Teaching Hospital Lusaka
Semrau, Katherine E.A.
United States, Boston
School of Public Health
Kasonde, Prisca
Zambia, Lusaka
University Teaching Hospital Lusaka
Scott, Nancy A.
United States, Boston
School of Public Health
Mwiya, Mwiya
Zambia, Lusaka
University Teaching Hospital Lusaka
Vwalika, Cheswa M.
Zambia, Lusaka
Lusaka District Health Management Team
Walter, Jan
United States, New York
Gertrude H. Sergievsky Center
Tsai, Wei Yann
United States, New York
Mailman School of Public Health
Aldrovandi, Grace M.
United States, Los Angeles
University of Southern California
Thea, Donald M.
United States, Boston
School of Public Health
Statistics
Citations: 153
Authors: 12
Affiliations: 6
Identifiers
Doi:
10.1371/journal.pone.0001363
e-ISSN:
19326203
Research Areas
Environmental
Infectious Diseases
Maternal And Child Health
Study Design
Cohort Study
Study Locations
Zambia
Participants Gender
Female