Acceptability of exclusive breast-feeding with early cessation to prevent HIV transmission through breast milk, ANRS 1201/1202 Ditrame Plus, Abidjan, Côte d'Ivoire.
OBJECTIVE
We assessed the uptake of a nutritional intervention promoting exclusive breast-feeding with early cessation between 3 and 4 months of age to reduce postnatal transmission of HIV in Abidjan, Côte d'Ivoire.


METHODS
Between March 2001 and March 2003, HIV-infected pregnant women who had received perinatal antiretroviral prophylaxis were systematically offered prenatally 2 infant feeding interventions: artificial feeding or exclusive breast-feeding during 3 months and then early cessation of breast-feeding. Mother-infant pairs were closely followed for a period of 2 years, with continuous nutritional counseling and detailed collection of feeding practices.


RESULTS
Among the 557 mothers enrolled, 262 (47%) initiated breast-feeding. Of these women, the probability of practicing exclusive breast-feeding from birth was 18% and 10% at 1 and 3 months of age, respectively. Complete cessation of breast-feeding was obtained in 45% and 63% by 4 and 6 months of age, respectively. Environmental factors such as living with a partner's family were associated with failure to initiate early cessation of breast-feeding.


CONCLUSIONS
Acceptability of exclusive breast-feeding was low in this urban population. Shortening the duration of breast-feeding seemed to be feasible, however. Further investigations are ongoing to evaluate the safety and effectiveness of this intervention in reducing breast milk HIV transmission.
Becquet
Renaud
R
Unité INSERM 593, Institut de Santé Publique Epidémiologie Développement (ISPE), Université Victor Segalen, Bordeaux, France. Renaud.Becquet@isped.u-bordeaux2.fr
Ekouevi
Didier K
DK
Viho
Ida
I
Sakarovitch
Charlotte
C
Toure
Hassan
H
Castetbon
Katia
K
Coulibaly
Nacoumba
N
Timite-Konan
Marguerite
M
Bequet
Laurence
L
Dabis
François
F
Leroy
Valériane
V
D001942:Breast Feeding; D015331:Cohort Studies; D007560:Cote d'Ivoire; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission*; D006801:Humans; D007223:Infant; D007225:Infant Food; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008895:Milk, Human / Q000821:virology*; D010342:Patient Acceptance of Health Care; D013997:Time Factors; D014886:Weaning