Acceptability of exclusive breast-feeding with early cessation to prevent HIV transmission through breast milk, ANRS 1201/1202 Ditrame Plus, Abidjan, Côte d'Ivoire
Becquet, R.; Ekouevi, D.K.; Viho, I.; Sakarovitch, C.; Toure, H.; Castetbon, K.; Coulibaly, N.; Timite-Konan, M.; Bequet, L.; Dabis, Fçois.; Leroy, Vériane.
Journal of Acquired Immune Deficiency Syndromes 40(5): 600-608
2005
ISSN/ISBN: 1525-4135 PMID: 16284538 DOI: 10.1097/01.qai.0000171726.17436.82Document Number: 259238
We assessed the uptake of a nutritional intervention promoting exclusive breast-feeding with early cessation between 3 and 4 months of age to reduce postnatal transmission of HIV in Abidjan, Côte d'Ivoire. Between March 2001 and March 2003, HIV-infected pregnant women who had received perinatal antiretroviral prophylaxis were systematically offered prenatally 2 infant feeding interventions: artificial feeding or exclusive breast-feeding during 3 months and then early cessation of breast-feeding. Mother-infant pairs were closely followed for a period of 2 years, with continuous nutritional counseling and detailed collection of feeding practices. Among the 557 mothers enrolled, 262 (47%) initiated breast-feeding. Of these women, the probability of practicing exclusive breast-feeding from birth was 18% and 10% at 1 and 3 months of age, respectively. Complete cessation of breast-feeding was obtained in 45% and 63% by 4 and 6 months of age, respectively. Environmental factors such as living with a partner's family were associated with failure to initiate early cessation of breast-feeding. Acceptability of exclusive breast-feeding was low in this urban population. Shortening the duration of breast-feeding seemed to be feasible, however. Further investigations are ongoing to evaluate the safety and effectiveness of this intervention in reducing breast milk HIV transmission.