ArticleBMC public health2024
How women living with HIV in the UK manage infant-feeding decisions and vertical transmission risk - a qualitative study.
Article in BMC public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Perinatal HIV in Europe: Clinical Advances and Psychosocial Challenges-A Scoping Review.Tropical medicine and infectious disease · 2026Review
- "I love my baby more than they do": infant feeding decision-making among mothers living with HIV in the United States.AIDS care · 2026Article
- Infant feeding decisions among people living with human immunodeficiency virus in the United States: a pilot study.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
- "It's exactly what's needed": a call to action for breastmilk studies of vertical HIV transmission in high-income countries.Frontiers in reproductive health · 2026Article
- Hearing the Silence and Silenced: Co-Producing Research on Infant-Feeding Experiences and Practices With Black Women With HIV.Sociology of health & illness · 2025Article
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Authors and funding
7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe World Health Organization (WHO) recommends that women with HIV breastfeed for a minimum of one year. In contrast, across high-income countries, HIV and infant-feeding guidelines recommend exclusive formula feeding if parents want to avoid all risk of postpartum transmission. However, recently these guidelines (including in the United Kingdom (UK)) increasingly state that individuals with HIV should be supported to breast/chest feed if they meet certain criteria; such as an undetectable maternal HIV viral load and consent to additional clinical monitoring. Between 600 and 800 pregnancies are reported annually in women with HIV in the UK, with low rates of vertical transmission (0.22%). Informed infant-feeding decision-making requires clinical support. Currently, little research addresses how individuals with HIV in high-income countries navigate infant-feeding decisions with their clinical teams and familial and social networks, and the resources needed to reach an informed decision.
methodsSemi-structured remote interviews were conducted between April 2021 - January 2022 with UK-based individuals with a confirmed HIV diagnosis who were pregnant or one-year postpartum. Using purposive sampling, pregnant and postpartum participants were recruited through NHS HIV clinics, community-based organisations and snowballing. Data were analysed thematically and organised using NVivo 12.
resultsOf the 36 cisgender women interviewed, 28 were postpartum. The majority were of Black African descent (n = 22) and born outside the UK. The majority of postpartum women had chosen to formula feed. Women's decision-making regarding infant-feeding was determined by (1) information and support; (2) practicalities of implementing medical guidance; (3) social implications of infant-feeding decisions.
conclusionThe evolution of UK HIV and infant-feeding guidelines are not reflected in the experiences of women living with HIV. Clinicians' emphasis on reducing the risk of vertical transmission, without adequately considering personal, social and financial concerns, prevents women from making fully informed infant-feeding decisions. For some, seeking advice beyond their immediate clinical team was key to feeling empowered in their decision. The significant informational and support need among women with HIV around their infant-feeding options must be addressed. Furthermore, training for and communication by healthcare professionals supporting women with HIV is essential if women are to make fully informed decisions.
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