title: Knowledge and practice of prechewing/prewarming food by HIV-infected women.
abstract: OBJECTIVE
  HIV transmission has been associated with offering a child food prechewed by an HIV-infected caregiver. We assessed awareness of prechewing and oral prewarming of food by an adult before offering it to a child among HIV-infected pregnant women and clinical investigators in 3 Latin American countries.
  
  
  METHODS
  HIV-infected pregnant women at 12 sites (Eunice Kennedy Shriver National Institute of Child Health and Human Development International Site Development Initiative Perinatal Longitudinal Study in Latin American Countries, a prospective cohort trial) in Argentina, Brazil, and Peru were administered a screening survey about prechewing/prewarming of infant foods and cautioned against these feeding practices. Survey responses were analyzed, overall, and stratified according to country.
  
  
  RESULTS
  Of the 401 HIV-infected pregnant women interviewed, 34% had heard about prechewing (50% from Argentina, 32% from Brazil, and 36% from Peru), 23% knew someone who prechewed food for infants, and 4% had prechewed food in the past. Seventeen percent had heard about oral prewarming of food, 13% knew someone who prewarmed food for infants, and 3% had prewarmed food for an infant in the past. Women who reported knowing someone who prechewed were more likely to also know someone who prewarmed food (P < .0001). Few site investigators anticipated that their patients would be aware of these practices.
  
  
  CONCLUSIONS
  Prechewing food, a potential risk factor for HIV transmission, and orally prewarming food, which has not been associated with HIV transmission but might expose a child to blood from an HIV-infected adult, are not uncommon practices in Latin America. Both practices should be further investigated. Site investigator responses underscore that health care providers could be missing information about cultural practices that patients may not report unless specifically asked.
authors.affiliation: Department of Infectious Diseases [MS 600], St Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis TN 38105, USA. aditya.gaur@stjude.org
authors.forename: Aditya H
authors.initials: AH
authors.lastname: Gaur
authors.forename: Laura
authors.initials: L
authors.lastname: Freimanis-Hance
authors.forename: Kenneth
authors.initials: K
authors.lastname: Dominguez
authors.forename: Charles
authors.initials: C
authors.lastname: Mitchell
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Menezes
authors.forename: Marisa M
authors.initials: MM
authors.lastname: Mussi-Pinhata
authors.forename: Mario F
authors.initials: MF
authors.lastname: Peixoto
authors.forename: Jorge
authors.initials: J
authors.lastname: Alarcon
authors.forename: Debora F
authors.initials: DF
authors.lastname: Coelho
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Read
mesh_terms: D000328:Adult; D001118:Argentina; D001938:Brazil; D002675:Child, Preschool; D015331:Cohort Studies; D018562:Disease Transmission, Infectious / Q000517:prevention & control* / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission*; D006679:HIV Seropositivity; D006266:Health Education / Q000458:organization & administration; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007224:Infant Care / Q000379:methods*; D007225:Infant Food / Q000821:virology*; D008297:Male; D008409:Mastication; D009034:Mother-Child Relations; D020380:Needs Assessment; D010568:Peru; D011446:Prospective Studies