title: Infants of human immunodeficiency virus type 1-infected women in rural south India: feeding patterns and risk of mother-to-child transmission.
abstract: BACKGROUND
  We assessed the infant feeding choices of HIV-1-infected women in rural Tamil Nadu, India, and risk factors for mother-to-child transmission of HIV-1.
  
  
  METHODS
  The study population comprised live born infants of HIV-1-infected women from the antenatal clinics of 2 public hospitals in rural Tamil Nadu, India who were enrolled in a prospective cohort study. All women enrolled in the cohort were offered antiretroviral prophylaxis and infant feeding counseling based on WHO/UNAIDS/UNICEF training materials. Infant study visits were scheduled at birth (within the first 24 hours of life), at 1 week, 1 month, and 2 months after birth, and then every 2 months between 4 and 12 months of age.
  
  
  RESULTS
  One-third of women did not breast-feed their infants. Of those who initiated breast-feeding, the median duration of breast-feeding was approximately 3 months. Among those infants who initiated breast-feeding, the proportion exclusively breast-feeding declined from approximately 70% during the first week of life to 0% by the 8 month visit. The observed rate of mother-to-child transmission of HIV-1 in the entire cohort was 6.5% (95% CI: 1.4%-17.9%). The observed HIV-1 incidence among breast-fed infants was 0% (95% CI: 0%-8.9%).
  
  
  CONCLUSIONS
  The overall transmission rate was relatively low, suggesting effectiveness of antiretroviral transmission prophylaxis. The infant feeding choices made may reflect knowledge gained through the educational program and infant feeding counseling provided. Ensuring HIV-1-infected women receive appropriate HIV-1 treatment (for those who meet criteria for treatment) and access to known efficacious interventions to prevent mother-to-child transmission of HIV-1, are essential.
authors.affiliation: Pediatric, Adolescent, and Maternal AIDS Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health Executive Building, Room 4B11C, 6100 Executive Boulevard MSC 7510, Bethesda, MD 20892-7510. jennifer_read@nih.gov
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Read
authors.forename: N M
authors.initials: NM
authors.lastname: Samuel
authors.forename: Parameshwari
authors.initials: P
authors.lastname: Srijayanth
authors.forename: Shoba
authors.initials: S
authors.lastname: Dharmarajan
authors.forename: Hannah M
authors.initials: HM
authors.lastname: Van Hook
authors.forename: Mini
authors.initials: M
authors.lastname: Jacob
authors.forename: Viju
authors.initials: V
authors.lastname: Junankar
authors.forename: James
authors.initials: J
authors.lastname: Bethel
authors.forename: Eunice
authors.initials: E
authors.lastname: Yu
authors.forename: Sonia K
authors.initials: SK
authors.lastname: Stoszek
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use; D001942:Breast Feeding / Q000009:adverse effects*; D015331:Cohort Studies; D005247:Feeding Behavior; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission*; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D011247:Pregnancy; D011446:Prospective Studies; D018570:Risk Assessment; D012424:Rural Population
chemical_list: D019380:Anti-HIV Agents