title: Predictors of early breastfeeding cessation among HIV-infected women in Botswana.
abstract: OBJECTIVE
  Infants born to HIV-infected women receiving antiretroviral treatment (ART) can be breastfed through at least 6 months with very low risk of HIV acquisition. We aimed to identify demographic and cultural factors that may influence mothers' willingness to breastfeed for the recommended duration.
  
  
  METHODS
  We evaluated factors associated with early cessation of breastfeeding (i.e. before 5 months post-partum) in a randomized clinical trial evaluating different ART regimens used for prevention of mother-to-child transmission during breastfeeding in Botswana. Univariate and multivariable Cox regressions were used to describe predictors of early exclusive BF cessation.
  
  
  RESULTS
  Among 677 women who started breastfeeding, the median time to breastfeeding cessation was 178 days (IQR 150-181) and 25.1% weaned early. In multivariable analysis, urban location (aHR = 1.86 95%CI 1.27-2.73; P = 0.002), salaried employment or being a student (aHR = 2.78 95% CI 1.63-4.75; P < 0.001) and infant hospitalisation before weaning (aHR = 2.04 95% CI 1.21-3.45; P = 0.008) were independently and significantly associated with early BF cessation.
  
  
  CONCLUSIONS
  Improved support for breastfeeding among employed mothers, especially in urban settings, may allow HIV-infected women who are receiving ART prophylaxis to breastfeed longer.
authors.affiliation: Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.|Harvard T.H. Chan School of Public Health, Boston, MA, USA.|Trinity Medical Centre, Piccadilly, WA, Australia.
authors.forename: Anthony
authors.initials: A
authors.lastname: Ogwu
authors.affiliation: Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.|Division of Medical Virology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
authors.forename: Sikhulile
authors.initials: S
authors.lastname: Moyo
authors.affiliation: Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.|Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Powis
authors.affiliation: Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.|Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Aida
authors.initials: A
authors.lastname: Asmelash
authors.affiliation: Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.|Harvard T.H. Chan School of Public Health, Boston, MA, USA.|Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Shahin
authors.initials: S
authors.lastname: Lockman
authors.affiliation: Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.|Greater Manchester West Mental Health NHS Foundation Trust, Prestwich, UK.
authors.forename: Claire
authors.initials: C
authors.lastname: Moffat
authors.affiliation: Goodtables Data Consulting, Norman, OK, USA.
authors.forename: Jean
authors.initials: J
authors.lastname: Leidner
authors.affiliation: Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.|Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Makhema
authors.affiliation: Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.|Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Max
authors.initials: M
authors.lastname: Essex
authors.affiliation: Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.|Harvard T.H. Chan School of Public Health, Boston, MA, USA.|Beth Israel Deaconess Medical Center, Boston, MA, USA.
authors.forename: Roger
authors.initials: R
authors.lastname: Shapiro
keywords: 
  HIV
  ; 
  PMTCT
  ; 
  PTME
  ; 
  VIH
  ; Botswana; allaitement maternel; breastfeeding; lactancia; prevención de la transmisión vertical