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Reducing perinatal HIV transmission in developing countries through antenatal and delivery care, and breastfeeding: supporting infant survival by supporting women's survival.
Bull World Health Organ 1999; 77(11):871-7BW

Abstract

In 1998, a joint UNAIDS/UNICEF/WHO working group announced an initiative to pilot test an intervention to reduce perinatal transmission of human immunodeficiency virus (HIV), based on new guidelines on HIV and infant feeding. This intervention for developing countries includes short-course perinatal zidovudine (AZT) treatment and advice to HIV-positive women not to breastfeed their infants, where this can be done safely. The present paper raises questions about the extent of the public health benefit of this intervention, even though it may be cost-effective, due to the limited capacity of antenatal and delivery services to implement it fully. It argues that it is necessary to provide universal access to replacement feeding methods and support in their safe use, not only for women who have tested HIV-positive during pregnancy, but also for untested women who may also decide not to breastfeed, some of whom may be infected with HIV or may acquire HIV during the breastfeeding period. It further argues that additional funding, more staff, staff training, and improved capacity and resources are also needed to integrate this intervention successfully into antenatal and delivery care. The intervention will prevent some infants from getting HIV even in the absence of many of these changes. However, a comprehensive approach to HIV prevention and care in developing countries that includes both women and infants would promote better health and survival of women, which would in turn contribute to greater infant health and survival. If combination antiretroviral therapy in the latter part of pregnancy and/or during the breastfeeding period can be shown to be safe for infants, preliminary evidence suggests that it might reduce perinatal HIV transmission as effectively as the current intervention and, in addition, might allow the practice of breastfeeding to be preserved.

Authors

No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10612882

Citation

Berer, M. "Reducing Perinatal HIV Transmission in Developing Countries Through Antenatal and Delivery Care, and Breastfeeding: Supporting Infant Survival By Supporting Women's Survival." Bulletin of the World Health Organization, vol. 77, no. 11, 1999, pp. 871-7.
Berer M. Reducing perinatal HIV transmission in developing countries through antenatal and delivery care, and breastfeeding: supporting infant survival by supporting women's survival. Bull World Health Organ. 1999;77(11):871-7.
Berer, M. (1999). Reducing perinatal HIV transmission in developing countries through antenatal and delivery care, and breastfeeding: supporting infant survival by supporting women's survival. Bulletin of the World Health Organization, 77(11), pp. 871-7.
Berer M. Reducing Perinatal HIV Transmission in Developing Countries Through Antenatal and Delivery Care, and Breastfeeding: Supporting Infant Survival By Supporting Women's Survival. Bull World Health Organ. 1999;77(11):871-7. PubMed PMID: 10612882.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reducing perinatal HIV transmission in developing countries through antenatal and delivery care, and breastfeeding: supporting infant survival by supporting women's survival. A1 - Berer,M, PY - 1999/12/29/pubmed PY - 1999/12/29/medline PY - 1999/12/29/entrez KW - Breast Feeding KW - Child Health KW - Child Survival KW - Delivery Of Health Care KW - Demographic Factors KW - Developing Countries KW - Diseases KW - Health KW - Health Services KW - Hiv Infections KW - Infant Nutrition KW - Length Of Life KW - Maternal Health Services KW - Maternal-child Health Services KW - Mortality KW - Nutrition KW - Population KW - Population Dynamics KW - Primary Health Care KW - Summary Report KW - Survivorship KW - Treatment KW - Viral Diseases SP - 871 EP - 7 JF - Bulletin of the World Health Organization JO - Bull. World Health Organ. VL - 77 IS - 11 N2 - In 1998, a joint UNAIDS/UNICEF/WHO working group announced an initiative to pilot test an intervention to reduce perinatal transmission of human immunodeficiency virus (HIV), based on new guidelines on HIV and infant feeding. This intervention for developing countries includes short-course perinatal zidovudine (AZT) treatment and advice to HIV-positive women not to breastfeed their infants, where this can be done safely. The present paper raises questions about the extent of the public health benefit of this intervention, even though it may be cost-effective, due to the limited capacity of antenatal and delivery services to implement it fully. It argues that it is necessary to provide universal access to replacement feeding methods and support in their safe use, not only for women who have tested HIV-positive during pregnancy, but also for untested women who may also decide not to breastfeed, some of whom may be infected with HIV or may acquire HIV during the breastfeeding period. It further argues that additional funding, more staff, staff training, and improved capacity and resources are also needed to integrate this intervention successfully into antenatal and delivery care. The intervention will prevent some infants from getting HIV even in the absence of many of these changes. However, a comprehensive approach to HIV prevention and care in developing countries that includes both women and infants would promote better health and survival of women, which would in turn contribute to greater infant health and survival. If combination antiretroviral therapy in the latter part of pregnancy and/or during the breastfeeding period can be shown to be safe for infants, preliminary evidence suggests that it might reduce perinatal HIV transmission as effectively as the current intervention and, in addition, might allow the practice of breastfeeding to be preserved. SN - 0042-9686 UR - https://www.unboundmedicine.com/medline/citation/10612882/Reducing_perinatal_HIV_transmission_in_developing_countries_through_antenatal_and_delivery_care_and_breastfeeding:_supporting_infant_survival_by_supporting_women's_survival_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/10612882/ DB - PRIME DP - Unbound Medicine ER -