In sub-Saharan Africa, women may face stigma anddiscrimination if they don't breastfeed their babies. That's because manybelieve those women have HIV/AIDS.
However, new research shows treatment can allowwomen to breastfeed despite their HIV-positive status. The findings werereleased this week at a major AIDS conference in Cape Town, South Africa.
Research conducted in Cameroon, Ivory Coast, SouthAfrica and Zambia shows that the risk of HIV transmission can be greatly reducedduring breastfeeding.
Dr. Laura Guay is vice-president of research for theElizabeth Glaser Pediatric AIDS Foundation, which supported the research.
"We know that women who breastfeed are at risk oftransmitting the infection to their baby in a small percent duringbreastfeeding. But that the risk of not breastfeeding is quite high in terms ofdeath or illnesses. So, the studies were looking at ways that would allow womenwho are HIV infected to continue to breastfeed," she says.
Guay says two studies looked at the best ways toprevent HIV infection in infants.
"One was to provide the mother who HIV was infectedwith three anti-HIV drugs that she would continue to take during thebreastfeeding period for up to six months during breastfeeding," she says.
The other method tested, she says, "was instead ofgiving the mother multiple drugs, could you provide the baby that is HIVnegative with one anti HIV drug. And give the baby the drug everyday whilebreastfeeding for six months."
Both methods proved effective. Shorter studies hadbeen done earlier on giving infants anti-retrovirals.
The women taking part in the study had not been on AIDSdrugs because their immune systems had not yet been ravaged by HIV.
However, the emerging view is that anyone infectedwith HIV should be on anti-retrovirals. This could help prevent immune systemdamage in the first place.
"We know for sure that all women who are immune-compromised or don't have a strong immune system needing HIV therapy should beon it. And that is across the board," she says.
The findings have not been put into general practiceyet.
"So the challenge will now be to take theinformation that we know and see how these practices would be implemented inthe field," he says.
A report known as the PEARL study shows that womenwho actually took part and completed treatment "varied greatly by country andfacility."
The problem is access. The Glaser Foundation saysfew women in sub-Saharan Africa have access to even simple drug regimens.
"We know that only about 33 percent of women? haveaccess to a program that actually has services in place to preventmother-to-child transmission. So the first challenge is how do we reach all thewomen who do not have access to a prevention program.
And once treatment is made available, anotherchallenge is to make sure women stay on it.
"Can you do outreach in the community, educating thepopulation? Having community health workers try to identify where pregnantwomen are. Using peers or women that have been through the program to try toget the message out there," she says.
She says men should play a role as well.
"If you have a partner that's pregnant, it'simportant for all of her health to come to (an)ante-natal clinic," she says.
Not breastfeeding when HIV positive is the best way toprevent infection in infants. But it cancause other problems. Over theHIV/AIDS pandemic, many women became outcasts for not breastfeeding.
"We knew that the most important part that we coulddo was to allow women to breastfeed - but really look at ways they could do itsafely," Guay says.
The Elizabeth Glaser Pediatric AIDS Foundation isone of the leading groups providing treatment for women and children in Africa.It's operated programs in developing countries for the past 20 years.