In:
JAIDS Journal of Acquired Immune Deficiency Syndromes, Ovid Technologies (Wolters Kluwer Health), ( 2023-09-15)
Abstract:
Lifelong ART use is recommended for pregnant and breastfeeding women living with HIV (WLWH) to prevent perinatal HIV transmission and improve maternal health. We address two objectives in this analysis: (1) determine timing and factors associated with breastfeeding cessation, and (2) assess the impact of breastfeeding on health of women living with HIV on ART. Setting: Multi-country study of eight sites in Uganda, Malawi, Zimbabwe and South Africa. Methods: 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 re-enrolled in an observational study (PROMOTE, 2016-2021) to assess ART adherence, safety, and impact. Results: The PROMOTE cohort included 1987 women on ART. Of these, 752 breastfed and were included in analyses of objective 1; all women were included in analyses of objective 2. Median time to breastfeeding cessation varied by country (11.2-19.7 months). Country of residence, age and health status of women were significantly associated with time to breastfeeding cessation (compared to Zimbabwe: Malawi, adjusted hazard ratio [aHR] 0.50, 95% CI 0.40-0.62, p 〈 0.001; South Africa, aHR 1.49, 95% CI 1.11-2.00, p=0.008; Uganda, aHR 1.77, 95% CI 1.37-2.29, p 〈 0.001). Women who breastfed had lower risk of being “unwell” compared to women who never breastfed (adjusted rate ratio [aRR] 0.87,95% CI 0.81-0.95 p=0.030). Conclusion: Women on lifelong ART should be encouraged to continue breastfeeding with no concern for their health. Time to breastfeeding cessation should be monitored for proper counseling in each country.
Type of Medium:
Online Resource
ISSN:
1525-4135
DOI:
10.1097/QAI.0000000000003306
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2023
detail.hit.zdb_id:
2038673-4
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