8946Imperial College Healthcare NHS Trust, London, UK.
215332Cambridgeshire Community Services NHS Trust, Huntingdon, UK.
Int J STD AIDS. 2021 Aug;32(9):856-860. doi: 10.1177/0956462421999951. Epub 2021 Feb 25.
The World Health Organisation advice for post-partum women living with HIV (WLHs) in low- and middle-income countries is to breastfeed on suppressive antiretroviral treatment and use infant postnatal prophylaxis. In resource-rich settings, where formula feeding is safe, avoidance of breastfeed is advised. A questionnaire was created to survey attitudes to breastfeeding in WLHs in the United Kingdom. This was offered to all eligible pregnant women in the third trimester or within 3 months post-partum who attended HIV outpatient clinics from 2017 to 2018. Ninety-four women completed the questionnaire, 69% were Black African and 92% had an undetectable HIV viral load. Thirty eight percent stated they would like to breastfeed and 89% said they would breastfeed if they were HIV negative. Sixty two percent had community members question why they did not breastfeed, and 66% felt forced to invent a reason why they were not breastfeeding. Current UK guidelines recommend formula feeding, proposing a harm reduction approach to support women with suppressed HIV who wish to breastfeed. Over a third of respondents said they would like to breastfeed because stigma and secrecy remain an issue for WLHs. This suggests that over time more women may choose this option.
世界卫生组织（WHO）为中低收入国家的产后 HIV 感染者（WLH）提供了相关建议，即在接受抑制性抗逆转录病毒治疗的同时母乳喂养，并为婴儿提供产后预防措施。在资源丰富的环境中，如果配方奶喂养是安全的，则建议避免母乳喂养。我们制定了一份问卷，以调查英国 WLH 对母乳喂养的态度。该问卷于 2017 年至 2018 年期间向所有在第三孕期或产后 3 个月内到 HIV 门诊就诊的符合条件的孕妇发放。共有 94 名妇女完成了问卷调查，其中 69%为黑人非洲裔，92%的 HIV 病毒载量无法检测到。38%的人表示希望母乳喂养，如果她们 HIV 检测呈阴性，则有 89%的人表示会母乳喂养。62%的人表示有社区成员询问她们为什么不母乳喂养，66%的人感到被迫编造不母乳喂养的原因。目前英国的指南建议配方奶喂养，提出了一种减少危害的方法来支持希望母乳喂养且 HIV 得到抑制的妇女。超过三分之一的受访者表示希望母乳喂养，因为耻辱感和保密性仍然是 WLH 面临的问题。这表明随着时间的推移，可能会有更多的女性选择这种方式。
