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dc.contributor.authorKuhn, Louiseen_US
dc.contributor.authorSinkala, Mosesen_US
dc.contributor.authorKankasa, Chipepoen_US
dc.contributor.authorSemrau, Katherineen_US
dc.contributor.authorKasonde, Priscaen_US
dc.contributor.authorScott, Nancyen_US
dc.contributor.authorMwiya, Mwiyaen_US
dc.contributor.authorVwalika, Cheswaen_US
dc.contributor.authorWalter, Janen_US
dc.contributor.authorTsai, Wei-Yannen_US
dc.contributor.authorAldrovandi, Grace M.en_US
dc.contributor.authorThea, Donald M.en_US
dc.date.accessioned2012-01-11T21:43:54Z
dc.date.available2012-01-11T21:43:54Z
dc.date.issued2007-12-26en_US
dc.identifier.citationKuhn, Louise, Moses Sinkala, Chipepo Kankasa, Katherine Semrau, Prisca Kasonde, Nancy Scott, Mwiya Mwiya, Cheswa Vwalika, Jan Walter, Wei-Yann Tsai, Grace M. Aldrovandi, Donald M. Thea. "High Uptake of Exclusive Breastfeeding and Reduced Early Post-Natal HIV Transmission" PLoS ONE 2(12):e1363. (2007)en_US
dc.identifier.issn1932-6203en_US
dc.identifier.urihttp://hdl.handle.net/2144/3248
dc.description.abstractBACKGROUND. Empirical data showing the clear benefits of exclusive breastfeeding (EBF) for HIV prevention are needed to encourage implementation of lactation support programs for HIV-infected women in low resource settings among whom replacement feeding is unsafe. We conducted a prospective, observational study in Lusaka, Zambia, to test the hypothesis that EBF is associated with a lower risk of postnatal HIV transmission than non-EBF. METHODS AND RESULTS. As part of a randomized trial of early weaning, 958 HIV-infected women and their infants were recruited and all were encouraged to breastfeed exclusively to 4 months. Single-dose nevirapine was provided to prevent transmission. Regular samples were collected from infants to 24 months of age and tested by PCR. Detailed measurements of actual feeding behaviors were collected to examine, in an observational analysis, associations between feeding practices and postnatal HIV transmission. Uptake of EBF was high with 84% of women reporting only EBF cumulatively to 4 months. Post-natal HIV transmission before 4 months was significantly lower (p = 0.004) among EBF (0.040 95% CI: 0.024–0.055) than non-EBF infants (0.102 95% CI: 0.047–0.157); time-dependent Relative Hazard (RH) of transmission due to non-EBF = 3.48 (95% CI: 1.71–7.08). There were no significant differences in the severity of disease between EBF and non-EBF mothers and the association remained significant (RH = 2.68 95% CI: 1.28–5.62) after adjusting for maternal CD4 count, plasma viral load, syphilis screening results and low birth weight. CONCLUSIONS. Non-EBF more than doubles the risk of early postnatal HIV transmission. Programs to support EBF should be expanded universally in low resource settings. EBF is an affordable, feasible, acceptable, safe and sustainable practice that also reduces HIV transmission providing HIV-infected women with a means to protect their children's lives. TRIAL REGISTRATION. ClinicalTrials.gov NCT00310726en_US
dc.description.sponsorshipNational Institute of Child Health and Human Development; National Institutes of Health (R01 HD 39611, R01 HD 40777); Centers for Disease Control and Prevention; Global AIDS Program; Glaser Pediatric AIDS Foundation; USAID Country Research (GHS-A-00-00020-00)en_US
dc.language.isoenen_US
dc.publisherPublic Library of Scienceen_US
dc.titleHigh Uptake of Exclusive Breastfeeding and Reduced Early Post-Natal HIV Transmissionen_US
dc.typearticleen_US
dc.identifier.doi10.1371/journal.pone.0001363en_US
dc.identifier.pubmedid18159246en_US
dc.identifier.pmcid2137948en_US


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