{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T15:16:41Z","timestamp":1787325401797,"version":"build-2736575974"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T00:00:00Z","timestamp":1681948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01CA250850"],"award-info":[{"award-number":["R01CA250850"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 HD101352"],"award-info":[{"award-number":["R01 HD101352"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 AI34363"],"award-info":[{"award-number":["R01 AI34363"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["HHSN2612012000311 and"],"award-info":[{"award-number":["HHSN2612012000311 and"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["HHSN2612012000351"],"award-info":[{"award-number":["HHSN2612012000351"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In North American countries, national guidelines have strongly recommended formula over breastmilk for people with human immunodeficiency virus (HIV) because of concern for HIV transmission. However, data from resource-limited settings suggest the risk is &amp;lt;1% among virally suppressed people. Information regarding breastfeeding experience in high-resource settings is lacking.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective multisite study was performed for individuals with HIV who breastfed during 2014\u20132022 in the United States (8 sites) and Canada (3 sites). Descriptive statistics were used for data analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among the 72 cases reported, most had been diagnosed with HIV and were on antiretroviral therapy prior to the index pregnancy and had undetectable viral loads at delivery. Most commonly reported reasons for choosing to breastfeed were health benefits, community expectations, and parent\u2013child bonding. Median duration of breastfeeding was 24 weeks (range, 1 day to 72 weeks). Regimens for infant prophylaxis and protocols for testing of infants and birthing parents varied widely among institutions. No neonatal transmissions occurred among the 94% of infants for whom results were available \u22656 weeks after weaning.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study describes the largest cohort to date of people with HIV who breastfed in North America. Findings demonstrate high variability among institutions in policies, infant prophylaxis, and infant and parental testing practices. The study describes challenges in weighing the potential risks of transmission with personal and community factors. Finally, this study highlights the relatively small numbers of patients with HIV who chose to breastfeed at any 1 location, and the need for further multisite studies to identify best care practices.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciad235","type":"journal-article","created":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T14:23:18Z","timestamp":1682000598000},"page":"1416-1422","source":"Crossref","is-referenced-by-count":31,"title":["Breastfeeding Among People With Human Immunodeficiency Virus in North America: A Multisite Study"],"prefix":"10.1093","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2431-662X","authenticated-orcid":false,"given":"Judy","family":"Levison","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Baylor College of Medicine , Houston, Texas , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1641-9610","authenticated-orcid":false,"given":"Jennifer","family":"McKinney","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Baylor College of Medicine , Houston, Texas , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandra","family":"Duque","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Baylor College of Medicine , Houston, Texas , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Hawkins","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Baylor College of Medicine , Houston, Texas , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily Ver Hoeve","family":"Bowden","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Baylor College of Medicine , Houston, Texas , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Dorland","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Texas at Austin Dell Medical School , Austin, Texas , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ari","family":"Bitnun","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Toronto, Hospital for Sick Children , Toronto , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kescha","family":"Kazmi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Toronto, Hospital for Sick Children , Toronto , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas M","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Toronto, St. Michael's Hospital , Toronto , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"MacGillivray","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Toronto, St. Michael's Hospital , Toronto , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark H","family":"Yudin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Toronto, St. Michael's Hospital , Toronto , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Powell","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Johns Hopkins School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shreetoma","family":"Datta","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Johns Hopkins School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Abuogi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Colorado School of Medicine , Denver, Colorado , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Weinberg","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Colorado School of Medicine , Denver, Colorado , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natella","family":"Rakhmanina","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children's National Hospital, The George Washington University School of Medicine and Health Sciences , Washington, District of Columbia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna Walsh","family":"Mareuil","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children's National Hospital, The George Washington University School of Medicine and Health Sciences , Washington, District of Columbia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Hitti","sequence":"additional","affiliation":[{"name":"Department of Maternal Fetal Medicine, University of Washington School of Medicine , Seattle, Washington , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Boucoiran","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Montreal\/Centre Hospitalier Universitaire Sainte-Justine , Montreal, Quebec , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima","family":"Kakkar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Montreal , Montreal, Quebec , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Rahangdale","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of North Carolina School of Medicine , Chapel Hill, North Carolina , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominika","family":"Seidman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of California San Francisco , San Francisco, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Widener","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of South Carolina School of Medicine , Columbia, South Carolina , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,4,20]]},"reference":[{"key":"2024021012510200300_ciad235-B1","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.1093\/infdis\/jir019","article-title":"Early weaning increases diarrhea morbidity and mortality among uninfected children born to HIV-infected mothers in Zambia","volume":"203","author":"Fawzy","year":"2011","journal-title":"J Infect Dis"},{"key":"2024021012510200300_ciad235-B2","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1001\/jama.283.9.1167","article-title":"Effect of breastfeeding and formula feeding on transmission of HIV-1: a randomized clinical trial","volume":"283","author":"Nduati","year":"2000","journal-title":"JAMA"},{"key":"2024021012510200300_ciad235-B3","doi-asserted-by":"crossref","first-page":"21251","DOI":"10.7448\/IAS.20.1.21251","article-title":"Postnatal HIV transmission in breastfed infants of HIV-infected women on ART: a systematic review and meta-analysis","volume":"20","author":"Bispo","year":"2017","journal-title":"J Int AIDS Soc"},{"key":"2024021012510200300_ciad235-B4","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1097\/QAI.0000000000002744","article-title":"Association of maternal viral load and CD4 count with perinatal HIV-1 transmission risk during breastfeeding in the PROMISE postpartum component","volume":"88","author":"Flynn","year":"2021","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2024021012510200300_ciad235-B5","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1097\/QAI.0000000000001612","article-title":"Prevention of HIV-1 transmission through breastfeeding: efficacy and safety of maternal antiretroviral therapy versus infant nevirapine prophylaxis for duration of breastfeeding in HIV-1-infected women with high CD4 cell count (IMPAACT PROMISE): a randomized, open-label, clinical trial","volume":"77","author":"Flynn","year":"2018","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2024021012510200300_ciad235-B6","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1111\/joim.12986","article-title":"Women living with HIV in high-income settings and breastfeeding","volume":"287","author":"Moseholm","year":"2020","journal-title":"J Intern Med"},{"key":"2024021012510200300_ciad235-B7","doi-asserted-by":"crossref","first-page":"e25224","DOI":"10.1002\/jia2.25224","article-title":"In the United States, we say, \u2018No breastfeeding,\u2019 but that is no longer realistic: provider perspectives towards infant feeding among women living with HIV in the United States","volume":"22","author":"Tuthill","year":"2019","journal-title":"J Int AIDS Soc"},{"key":"2024021012510200300_ciad235-B8","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1080\/07399332.2014.888720","article-title":"\u201cWhy aren\u2019t you breastfeeding?\u201d: how mothers living with HIV talk about infant feeding in a \u201cbreast is best\u201d world","volume":"36","author":"Greene","year":"2015","journal-title":"Health Care Women Int"},{"key":"2024021012510200300_ciad235-B9","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1097\/JNC.0000000000000216","article-title":"It\u2019s not easy: infant feeding in the context of HIV in a resource-rich setting: strengths, challenges and choices, a qualitative study","volume":"32","author":"Khan","year":"2021","journal-title":"J Assoc Nurses AIDS Care"},{"key":"2024021012510200300_ciad235-B10","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1089\/heq.2020.0135","article-title":"We\u2019re still here: a photovoice study of mothers\u2019 perspectives 6 years after the Flint, Michigan water contamination event","volume":"5","author":"Craft-Blacksheare","year":"2021","journal-title":"Health Equity"},{"key":"2024021012510200300_ciad235-B11","article-title":"Jackson water crisis deepens as Mississippi deploys National Guard","author":"Felton","year":"2022","journal-title":"Washington Post."},{"key":"2024021012510200300_ciad235-B12","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/S0140-6736(22)00984-9","article-title":"Is the US infant formula shortage an avoidable crisis?","volume":"400","author":"Doherty","year":"2022","journal-title":"Lancet"},{"key":"2024021012510200300_ciad235-B13","doi-asserted-by":"crossref","first-page":"220","DOI":"10.3390\/idr14020027","article-title":"From undetectable equals untransmittable (U=U) to breastfeeding: is the jump short?","volume":"14","author":"Prestileo","year":"2022","journal-title":"Infect Dis Rep"},{"key":"2024021012510200300_ciad235-B14","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1097\/QAI.0000000000003075","article-title":"Brief report: HIV-positive and breastfeeding in high-income settings: 5-year experience from a perinatal center in Germany","volume":"91","author":"Weiss","year":"2022","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2024021012510200300_ciad235-B15","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1093\/jpids\/piz003","article-title":"Breastfeeding by women living with human immunodeficiency virus in a resource-rich setting: a case series of maternal and infant management and outcomes","volume":"9","author":"Nashid","year":"2020","journal-title":"J Pediatric Infect Dis Soc"},{"key":"2024021012510200300_ciad235-B16","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1093\/jpids\/piab116","article-title":"Experience and outcomes of breastfed infants of women living with HIV in the United States: findings from a single-center breastfeeding support initiative","volume":"11","author":"Yusuf","year":"2022","journal-title":"J Pediatric Infect Dis Soc"},{"key":"2024021012510200300_ciad235-B17","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1093\/jpids\/piac005","article-title":"Supporting mothers living with HIV in the United States who choose to breastfeed","volume":"11","author":"Koay","year":"2022","journal-title":"J Pediatric Infect Dis Soc"},{"key":"2024021012510200300_ciad235-B18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/hiv.12792","article-title":"Moving closer to what women want? A review of breastfeeding and women living with HIV in the UK and high-income countries","volume":"21","author":"Freeman-Romilly","year":"2020","journal-title":"HIV Med"},{"key":"2024021012510200300_ciad235-B19","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1177\/1073110519840495","article-title":"Breastfeeding with HIV: an evidence-based case for new policy","volume":"47","author":"Gross","year":"2019","journal-title":"J Law Med Ethics"},{"key":"2024021012510200300_ciad235-B20","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1016\/S0140-6736(99)01101-0","article-title":"Influence of infant-feeding patterns on early mother-to-child transmission of HIV-1 in Durban, South Africa: a prospective cohort study. South African Vitamin A Study Group","volume":"354","author":"Coutsoudis","year":"1999","journal-title":"Lancet"},{"key":"2024021012510200300_ciad235-B21","doi-asserted-by":"crossref","first-page":"2271","DOI":"10.1056\/NEJMoa0911486","article-title":"Maternal or infant antiretroviral drugs to reduce HIV-1 transmission","volume":"362","author":"Chasela","year":"2010","journal-title":"N Engl J Med"},{"key":"2024021012510200300_ciad235-B22","volume-title":"Guideline: updates on HIV and infant feeding: the duration of breastfeeding, and support from health services to improve feeding practices among mothers living with HIV","author":"World Health Organization (WHO)","year":"2016"},{"key":"2024021012510200300_ciad235-B23","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1089\/apc.2013.0005","article-title":"Adherence to antiretroviral treatment decreases during postpartum compared to pregnancy: a longitudinal electronic monitoring study","volume":"27","author":"Gertsch","year":"2013","journal-title":"AIDS Patient Care STDS"},{"key":"2024021012510200300_ciad235-B24","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1089\/apc.2012.0013","article-title":"Antiretroviral adherence during pregnancy and postpartum in Latin America","volume":"26","author":"Kreitchmann","year":"2012","journal-title":"AIDS Patient Care STDS"},{"key":"2024021012510200300_ciad235-B25","doi-asserted-by":"crossref","first-page":"1863","DOI":"10.1089\/jwh.2009.1880","article-title":"Follow-up care among HIV-infected pregnant women in Mississippi","volume":"19","author":"Rana","year":"2010","journal-title":"J Womens Health (Larchmt)"},{"key":"2024021012510200300_ciad235-B26","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1089\/apc.2013.0321","article-title":"Predictive factors for loss to postpartum follow-up among low income HIV-infected women in Texas","volume":"28","author":"Siddiqui","year":"2014","journal-title":"AIDS Patient Care STDS"},{"key":"2024021012510200300_ciad235-B27","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1093\/cid\/ciac761","article-title":"Providers have a responsibility to discuss options for infant feeding with pregnant people with HIV in high-income countries","volume":"76","author":"McKinney","year":"2023","journal-title":"Clin Infect Dis"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciad235\/51046241\/ciad235.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/77\/10\/1416\/56656686\/ciad235.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/77\/10\/1416\/56656686\/ciad235.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,10]],"date-time":"2024-02-10T12:51:48Z","timestamp":1707569508000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/77\/10\/1416\/7133158"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,20]]},"references-count":27,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2023,4,20]]},"published-print":{"date-parts":[[2023,11,17]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciad235","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,11,15]]},"published":{"date-parts":[[2023,4,20]]}}}