title: Acceptability of exclusive breast-feeding with early cessation to prevent HIV transmission through breast milk, ANRS 1201/1202 Ditrame Plus, Abidjan, Côte d'Ivoire.
abstract: 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.
authors.affiliation: Unité INSERM 593, Institut de Santé Publique Epidémiologie Développement (ISPE), Université Victor Segalen, Bordeaux, France. Renaud.Becquet@isped.u-bordeaux2.fr
authors.forename: Renaud
authors.initials: R
authors.lastname: Becquet
authors.forename: Didier K
authors.initials: DK
authors.lastname: Ekouevi
authors.forename: Ida
authors.initials: I
authors.lastname: Viho
authors.forename: Charlotte
authors.initials: C
authors.lastname: Sakarovitch
authors.forename: Hassan
authors.initials: H
authors.lastname: Toure
authors.forename: Katia
authors.initials: K
authors.lastname: Castetbon
authors.forename: Nacoumba
authors.initials: N
authors.lastname: Coulibaly
authors.forename: Marguerite
authors.initials: M
authors.lastname: Timite-Konan
authors.forename: Laurence
authors.initials: L
authors.lastname: Bequet
authors.forename: François
authors.initials: F
authors.lastname: Dabis
authors.forename: Valériane
authors.initials: V
authors.lastname: Leroy
mesh_terms: 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