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Acceptability of formula-feeding to prevent HIV postnatal transmission, Abidjan, Côte d'Ivoire: ANRS 1201/1202 Ditrame Plus Study.
J Acquir Immune Defic Syndr 2007; 44(1):77-86JA

Abstract

OBJECTIVE

To describe the maternal acceptability of formula-feeding proposed to reduce postnatal HIV transmission in Abidjan, Côte d'Ivoire.

METHODS

Each consenting HIV-infected pregnant women, age > or =18 years, who received a perinatal antiretroviral prophylaxis was eligible. Two hierarchical infant-feeding options were proposed antenatally: exclusive formula-feeding or short-term exclusive breast-feeding. Formula-feeding was provided free up to age 9 months. Determinants of acceptability were analyzed using a logistic regression. Formula-feeding failure was defined as having breast-fed one's child at least once.

RESULTS

Between March 2001 and March 2003, 580 women delivered: 97% expressed their infant-feeding choice before delivery; 53% chose formula-feeding. Significant prenatal determinants for refusing formula-feeding were: living with her partner, being Muslim, having a low educational level, being followed in one of the study sites, having not disclosed her HIV status, and having been included within the first 6 months of the project. Among the 295 mothers who formula-fed, the Kaplan-Meier probability of success of the formula-feeding option was 93.6% at Day 2 (95% confidence interval [CI]: 90.7% to 96.3%) and 84.2% at 12 months (95% CI: 79.9% to 88.5%): 46 of 295 (15.6%) women breast-fed at least once, of whom 41% temporarily practiced mixed-feeding at Day 2 because of social stigma or newborn poor health.

CONCLUSIONS

In settings with general access to clean water, structured antenatal counseling, and sustained provision of free formula, slightly over half of HIV-infected women chose to artificially feed their newborn infant. Low mixed-feeding rates were observed. This social acceptability must be balanced with mother-child long-term health outcomes to guide safe recommendations on infant-feeding among HIV-infected women in African urban settings.

Authors+Show Affiliations

INSERM, 593 Institut de Santé Publique, Epidémiologie et Développement (ISPED), Université Victor Segalen, Bordeaux, France. valeriane.leroy@isped.u-bordeaux2.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17031317

Citation

Leroy, Valériane, et al. "Acceptability of Formula-feeding to Prevent HIV Postnatal Transmission, Abidjan, Côte d'Ivoire: ANRS 1201/1202 Ditrame Plus Study." Journal of Acquired Immune Deficiency Syndromes (1999), vol. 44, no. 1, 2007, pp. 77-86.
Leroy V, Sakarovitch C, Viho I, et al. Acceptability of formula-feeding to prevent HIV postnatal transmission, Abidjan, Côte d'Ivoire: ANRS 1201/1202 Ditrame Plus Study. J Acquir Immune Defic Syndr. 2007;44(1):77-86.
Leroy, V., Sakarovitch, C., Viho, I., Becquet, R., Ekouevi, D. K., Bequet, L., ... Timite-Konan, M. (2007). Acceptability of formula-feeding to prevent HIV postnatal transmission, Abidjan, Côte d'Ivoire: ANRS 1201/1202 Ditrame Plus Study. Journal of Acquired Immune Deficiency Syndromes (1999), 44(1), pp. 77-86.
Leroy V, et al. Acceptability of Formula-feeding to Prevent HIV Postnatal Transmission, Abidjan, Côte d'Ivoire: ANRS 1201/1202 Ditrame Plus Study. J Acquir Immune Defic Syndr. 2007 Jan 1;44(1):77-86. PubMed PMID: 17031317.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acceptability of formula-feeding to prevent HIV postnatal transmission, Abidjan, Côte d'Ivoire: ANRS 1201/1202 Ditrame Plus Study. AU - Leroy,Valériane, AU - Sakarovitch,Charlotte, AU - Viho,Ida, AU - Becquet,Renaud, AU - Ekouevi,Didier Koumavi, AU - Bequet,Laurence, AU - Rouet,François, AU - Dabis,François, AU - Timite-Konan,Marguerite, AU - ,, PY - 2006/10/13/pubmed PY - 2007/3/3/medline PY - 2006/10/13/entrez SP - 77 EP - 86 JF - Journal of acquired immune deficiency syndromes (1999) JO - J. Acquir. Immune Defic. Syndr. VL - 44 IS - 1 N2 - OBJECTIVE: To describe the maternal acceptability of formula-feeding proposed to reduce postnatal HIV transmission in Abidjan, Côte d'Ivoire. METHODS: Each consenting HIV-infected pregnant women, age > or =18 years, who received a perinatal antiretroviral prophylaxis was eligible. Two hierarchical infant-feeding options were proposed antenatally: exclusive formula-feeding or short-term exclusive breast-feeding. Formula-feeding was provided free up to age 9 months. Determinants of acceptability were analyzed using a logistic regression. Formula-feeding failure was defined as having breast-fed one's child at least once. RESULTS: Between March 2001 and March 2003, 580 women delivered: 97% expressed their infant-feeding choice before delivery; 53% chose formula-feeding. Significant prenatal determinants for refusing formula-feeding were: living with her partner, being Muslim, having a low educational level, being followed in one of the study sites, having not disclosed her HIV status, and having been included within the first 6 months of the project. Among the 295 mothers who formula-fed, the Kaplan-Meier probability of success of the formula-feeding option was 93.6% at Day 2 (95% confidence interval [CI]: 90.7% to 96.3%) and 84.2% at 12 months (95% CI: 79.9% to 88.5%): 46 of 295 (15.6%) women breast-fed at least once, of whom 41% temporarily practiced mixed-feeding at Day 2 because of social stigma or newborn poor health. CONCLUSIONS: In settings with general access to clean water, structured antenatal counseling, and sustained provision of free formula, slightly over half of HIV-infected women chose to artificially feed their newborn infant. Low mixed-feeding rates were observed. This social acceptability must be balanced with mother-child long-term health outcomes to guide safe recommendations on infant-feeding among HIV-infected women in African urban settings. SN - 1525-4135 UR - https://www.unboundmedicine.com/medline/citation/17031317/Acceptability_of_formula_feeding_to_prevent_HIV_postnatal_transmission_Abidjan_Côte_d'Ivoire:_ANRS_1201/1202_Ditrame_Plus_Study_ L2 - http://Insights.ovid.com/pubmed?pmid=17031317 DB - PRIME DP - Unbound Medicine ER -