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High Uptake of Exclusive Breastfeeding and Reduced Early Post-Natal HIV Transmission

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dc.contributor.author Kuhn, Louise en_US
dc.contributor.author Sinkala, Moses en_US
dc.contributor.author Kankasa, Chipepo en_US
dc.contributor.author Semrau, Katherine en_US
dc.contributor.author Kasonde, Prisca en_US
dc.contributor.author Scott, Nancy en_US
dc.contributor.author Mwiya, Mwiya en_US
dc.contributor.author Vwalika, Cheswa en_US
dc.contributor.author Walter, Jan en_US
dc.contributor.author Tsai, Wei-Yann en_US
dc.contributor.author Aldrovandi, Grace M. en_US
dc.contributor.author Thea, Donald M. en_US
dc.date.accessioned 2012-01-11T21:43:54Z
dc.date.available 2012-01-11T21:43:54Z
dc.date.issued 2007-12-26 en_US
dc.identifier.citation Kuhn, Louise, Moses Sinkala, Chipepo Kankasa, Katherine Semrau, Prisca Kasonde, Nancy Scott, Mwiya Mwiya, Cheswa Vwalika, Jan Walter, Wei-Yann Tsai, Grace M. Aldrovandi, Donald M. Thea. "High Uptake of Exclusive Breastfeeding and Reduced Early Post-Natal HIV Transmission" PLoS ONE 2(12):e1363. (2007) en_US
dc.identifier.issn 1932-6203 en_US
dc.identifier.uri http://hdl.handle.net/2144/3248
dc.description.abstract 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. TRIAL REGISTRATION. ClinicalTrials.gov NCT00310726 en_US
dc.description.sponsorship National Institute of Child Health and Human Development; National Institutes of Health (R01 HD 39611, R01 HD 40777); Centers for Disease Control and Prevention; Global AIDS Program; Glaser Pediatric AIDS Foundation; USAID Country Research (GHS-A-00-00020-00) en_US
dc.language.iso en en_US
dc.publisher Public Library of Science en_US
dc.title High Uptake of Exclusive Breastfeeding and Reduced Early Post-Natal HIV Transmission en_US
dc.type article en_US
dc.identifier.doi 10.1371/journal.pone.0001363 en_US
dc.identifier.pubmedid 18159246 en_US
dc.identifier.pmcid 2137948 en_US


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