ArticleAIDS patient care and STDs2023
Tilting the Scale: Current Provider Perspectives and Practices on Breastfeeding with HIV in the United States.
Article in AIDS patient care and STDs, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- Navigating guidelines and realities: informed free choice in infant feeding for people living with HIV.Frontiers in reproductive health · 2026Article
- Breastfeeding practices and perspectives in the setting of maternal HIV in high-income countries since the shift in the United States national guidelines: a scoping review.Frontiers in reproductive health · 2026Review
- Multi-disciplinary support of infant feeding choice for parents living with HIV: experience across a guideline change.Frontiers in reproductive health · 2026Article
- Unlearning prohibition: the de-implementation of HIV breastfeeding restrictions in the United States.Frontiers in reproductive health · 2026Article
- Understanding practices of lactation and infant feeding together with women with HIV: the UPLIFT observational study protocol.Frontiers in reproductive health · 2026Article
- Evaluating infant feeding practice guidelines for individuals with HIV: a pilot study using qualitative findings with healthcare workers and normalization process theory.Frontiers in reproductive health · 2026Article
- Breastmilk transfer and infant exposure to atazanavir/ritonavir in breastfeeding women with HIV: results from IMPAACT 2026.Frontiers in reproductive health · 2026Article
- Breastfeeding with HIV: faculty and trainee clinical experience with updated 2023 HHS guidelines.Frontiers in reproductive health · 2026Article
- Adoption of the Revised DHHS Guidelines on Breastmilk Feeding and HIV in the United States: Clinical Practices and Barriers.Open forum infectious diseases · 2025Article
- HIV postnatal prophylaxis and infant feeding policies vary across Europe: results of a Penta survey.HIV medicine · 2025Article
- Lactation Support for Breastfeeding and Chestfeeding People with HIV: A Call for Research to Examine Telelactation Experience, HIV Knowledge, and Lactation Consultants' Attitudes Related to Infant Feeding with HIV.Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine · 2025Article
- Infant feeding knowledge among women living with HIV and their interaction with healthcare providers in a high-income setting: a longitudinal mixed methods study.International breastfeeding journal · 2024Article
- Overcoming Challenges during Breastfeeding to Prevent Perinatal HIV Transmission in Canada: A Case Series.The Canadian journal of hospital pharmacy · 2024Article
- Breastfeeding in women with HIV infection: A qualitative study of barriers and facilitators.PloS one · 2024Article
- 2023 updated guidelines on infant feeding and HIV in the United States: what are they and why have recommendations changed.Topics in antiviral medicine · 2023Article
- Importance of human milk for infants in the clinical setting: Updates and mechanistic links.Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition · 2023Review
- Opportunities and Constraints to Equitable Implementation of the Revised Infant Feeding Guidelines for Pregnant and Lactating Persons Living With HIV in the United States: A Qualitative Study.Journal of the International Association of Providers of AIDS CareArticle
- Effect of patient satisfaction on the utilization of mHealth services by patients with chronic disease.Digital healthArticle
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The risk of vertical transmission from breastfeeding with HIV (BFHIV) has been found to be very low in optimal scenarios with sustained maternal viral suppression during pregnancy and postpartum. Medical providers must account for the risk of this serious adverse event alongside parental autonomy, breastfeeding benefits, and patient values. To assess provider practices, comfort, and challenges with BFHIV, an online mixed-method survey was sent to breastfeeding and HIV provider listservs from June to July 2021. The target population was US medical professionals from diverse practice settings with experience in clinical issues associated with BFHIV, including physicians, advanced practice providers, nurses, and lactation consultants. Data analysis utilized nonparametric hypothesis testing, ordinal regression, and reflexive thematic analysis. Most providers reported counseling pregnant people with HIV on infant feeding choices, but fewer specifically endorsed counseling about breastfeeding. Of 84 unique institutions identified by 100 included respondents, 10% had an institutional protocol supporting BFHIV. Institutional protocols were associated with higher degrees of provider comfort with BFHIV in optimal scenario clinical vignettes. Providers perceived that White patients faced fewer BFHIV barriers than patients with other racial identities. Discomfort balancing the goals to protect infants from infection risk and support the parent's role in infant feeding decisions was a key theme in free text responses; this manifested in a spectrum of management styles ranging from patient's informed choice to paternalism. This study highlights the tension providers navigate regarding BFHIV discussions, calling for patient care guidelines and protocols grounded in risk reduction and respect of patient autonomy.
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