The Impact of Safer Breastfeeding Practices on Postnatal HIV-1 Transmission in Zimbabwe

• Published in: American journal of public health (1971) Vol. 97; no. 7; pp. 1249 - 1254
• Main Authors: Piwoz, Ellen G, Humphrey, Jean H, Tavengwa, Naume V, Iliff, Peter J, Marinda, Edmore T, Zunguza, Clare D, Nathoo, Kusum J, Mutasa, Kuda, Moulton, Lawrence H, Ward, Brian J
• Format: Journal Article
• Language: English
• Published: Washington, DC Am Public Health Assoc 01.07.2007; American Public Health Association; American Journal of Public Health 2007
• Subjects: Adult; AIDS Serodiagnosis; Babies; Biological and medical sciences; Breast Feeding; Breastfeeding & lactation; Brochures; Children & youth; Condoms; Counseling; Disease transmission; Enzyme-Linked Immunosorbent Assay; Female; Health Education - methods; HIV; HIV Infections - epidemiology; HIV Infections - prevention & control; HIV Infections - transmission; HIV-1; Human immunodeficiency virus; Human immunodeficiency virus 1; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infant; Infant, Newborn; Infectious Disease Transmission, Vertical - prevention & control; Infectious diseases; Medical sciences; Medical tests; Milk, Human - virology; Miscellaneous; Mothers; Outcome Assessment, Health Care; Polymerase Chain Reaction; Proportional Hazards Models; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Recruitment; Research and Practice; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Vitamin A; Zimbabwe - epidemiology; Zimbabwe; Africa; Social environment; Human; Immunopathology; HIV-1 virus; Transmission; Retroviridae; AIDS; Breast feeding; Health education; Sociocultural environment; Immune deficiency; Lentivirus; Infection; Virus; Postnatal; Viral disease; Human immunodeficiency virus; Safety; Public health
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.2006.085704

We assessed the association between exposure to an educational intervention that emphasized safer breastfeeding practices and postnatal HIV transmission among 437 HIV-positive mothers in Zimbabwe, 365 of whom did not know their infection status. Mothers were tested for HIV and were encouraged--but not required--to learn their HIV status. Intervention exposure was assessed by a questionnaire, Turnbull methods were used to estimate postnatal HIV transmission, and multivariate Cox proportional hazard models were constructed to assess the association between intervention exposure and postnatal HIV transmission. Cumulative postnatal HIV transmission was 8.2%; each additional intervention contact was associated with a 38% reduction in postnatal HIV transmission. HIV-positive mothers who were exposed to both print and video materials were 79% less likely to infect their infants compared with mothers who had no exposure. These findings were similar for mothers who did not know their HIV status. The promotion of exclusive breastfeeding has the potential to reduce postnatal HIV transmission among women who do not know their HIV status, and child survival and HIV prevention programs should support this practice.