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. 2023 May;18(5):356-361.
doi: 10.1089/bfm.2023.0004. Epub 2023 Apr 20.

Exploring the Breastfeeding Desires and Decision-Making of Women Living with HIV in the Netherlands: Implications for Perinatal HIV Management in Developed Countries

Vera E Bukkems  1 , Renee N N Finkenflügel  2 , Karin Grintjes  3 , Manon Marneef  3 , Martine de Haan  3 , Inga Mielitz  4 , Astrid van Hulzen  5 , Casper Rokx  6   7 , Elisabeth van Leeuwen  8 , Jeannine F Nellen  9 , David M Burger  1 , Angela Colbers  1
Affiliations

Exploring the Breastfeeding Desires and Decision-Making of Women Living with HIV in the Netherlands: Implications for Perinatal HIV Management in Developed Countries

Vera E Bukkems et al. Breastfeed Med. 2023 May.

Abstract

Introduction: Guidelines in high-income countries recommend women living with human immunodeficiency virus (HIV) to formula feed their newborns, because the possibility of mother-to-child-transmission of HIV during breastfeeding cannot be ruled out. It is an ongoing debate if the possible transmission risk outweighs the medical, cultural, psychological, and social importance of breastfeeding in women stable on current first-line suppressive antiretroviral regimens. The study aim was to explore breastfeeding desires and decision-making of immigrant and nonimmigrant women living with HIV in the Netherlands. Method: A questionnaire was administered orally or online to 82 women living with HIV in the Netherlands. The breastfeeding desires of the participants were collected as categorical data, and breastfeeding decision-making and willingness to adhere to additional monitoring were collected on a 5-point Likert scale. Categorical data were presented as proportions, and Likert scale data were presented in Likert scale bar plots. Results: Seventy-one percent of the participants expressed a desire to breastfeed in the future. The most important factors influencing decision-making to breastfeed were the chance of transmission of HIV to the infant and the advice by the doctor or nurse practitioner. Of the participants, 42% expressed their interest in breastfeeding with a <1/100 transmission risk. More than half of the participants expressed their interest to breastfeed with additional monitoring. Conclusions: A substantial proportion of the women living with HIV in the Netherlands has a desire to breastfeed, of which the majority are willing to adhere to additional monitoring to do so.

Keywords: HIV; antiretroviral agents; breastfeeding; mother-to-child transmission; patient-centered care; shared decision-making.

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Conflict of interest statement

C.R. has received study grants and/or honoraria from Janssen, Gilead, ViiV Healthcare, MSD, and Virology Education. J.F.N. has received honoraria paid to the institution from BMS, Gilead, ViiV Healthcare, GSK, and Virology Education. D.M.B. has received honoraria and/or study grants from Janssen, MSD, Gilead, and ViiV Healthcare. A.C. has received honoraria and/or study grants from Merck Sharp & Dohme Corp, Gilead and ViiV Healthcare fee is paid to the institution. V.E.B., R.N.N.F., K.G., M.M., M.d.H., I.M., A.v.H., and E.v.L. do not have conflicts of interest.

Figures

FIG. 1.
FIG. 1.
Response to the question to what extent the shown factors are/were influencing their decision to breastfeed or not. The left percentage depicts the percentage that completely disagrees or disagrees, whereas the percentage on the right represents the percentage that completely agrees or agrees. Participants could answer the questions by filling in a 5-point Likert scale and also had the option to enter “I don't know or not applicable” (not shown in the figure).
FIG. 2.
FIG. 2.
Response to the question to what extent the participants are would be willing/would have been willing to comply with the shown additional guidelines or accept the shown circumstances. The left percentage depicts the percentage that completely disagrees or disagrees, whereas the percentage on the right represents the percentage that completely agrees or agrees. Participants could answer the questions by filling in a 5-point Likert scale and also had the option to enter “I don't know or not applicable” (not shown in the figure).
See this image and copyright information in PMC

References

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