Breastfeeding Among Women Living With HIV in the Era of Lifelong ART: An Observational Multicountry Study in Eastern and Southern Africa.
J Acquir Immune Defic Syndr
; 95(1): 10-17, 2024 01 01.
Article
em En
| MEDLINE
| ID: mdl-37732877
ABSTRACT
BACKGROUND:
Lifelong antiretroviral treatment (ART) use is recommended for pregnant and breastfeeding (BF) women living with HIV (WLWH) to prevent perinatal HIV transmission and improve maternal health. We address 2 objectives in thisanalysis:
(1) determine timing and factors associated with BF cessation and (2) assess the impact of BF on health of WLWH on ART.SETTING:
This multicountry study included 8 sites in Uganda, Malawi, Zimbabwe, and South Africa.METHODS:
This was a prospective study of WLWH on lifelong ART. These women initially participated from 2011 to 2016 in a randomized clinical trial (PROMISE) to prevent perinatal HIV transmission and subsequently reenrolled in an observational study (PROMOTE, 2016-2021) to assess ART adherence, safety, and impact.RESULTS:
The PROMOTE cohort included 1987 women on ART. Of them, 752 breastfed and were included in analyses of objective 1; all women were included in analyses of objective 2. The median time to BF cessation varied by country (11.2-19.7 months). Country of residence, age, and health status of women were significantly associated with time to BF cessation (compared with Zimbabwe Malawi, adjusted hazard ratio [aHR] 0.50, 95% confidence interval [95% CI] 0.40 to 0.62, P < 0.001; South Africa, aHR 1.49, 95% CI 1.11 to 2.00, P = 0.008; and Uganda, aHR 1.77, 95% CI 1.37 to 2.29, P < 0.001). Women who breastfed had lower risk of being "unwell" compared with women who never breastfed (adjusted rate ratio 0.87, 95% CI 0.81 to 0.95 P = 0.030).CONCLUSION:
Women on lifelong ART should be encouraged to continue BF with no concern for their health. Time to BF cessation should be monitored for proper counseling in each country.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Aleitamento Materno
/
Infecções por HIV
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Risk_factors_studies
Aspecto:
Patient_preference
Limite:
Female
/
Humans
/
Pregnancy
País/Região como assunto:
Africa
Idioma:
En
Revista:
J Acquir Immune Defic Syndr
Assunto da revista:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Ano de publicação:
2024
Tipo de documento:
Article
País de publicação:
Estados Unidos