{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T18:19:36Z","timestamp":1787854776576,"version":"build-2784847793"},"reference-count":37,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>Human T-cell Lymphotropic Virus type 1 (HTLV-1) can be transmitted from mother to child through breastfeeding and increases the risk of mortality and morbidity from inflammatory, infectious and neoplastic diseases. Short-duration breastfeeding or exclusive formula feeding reduces transmission. In Peru, where breastfeeding is common and populations affected by HTLV-1 lack access to safe water and sewage, which hinders control, understanding women\u2019s knowledge, attitudes, and practices regarding HTLV-1 mother-to-child transmission (MTCT) is essential. We conducted a descriptive, exploratory cross-sectional survey at the Instituto de Medicina Tropical Alexander von Humboldt (Lima, Peru) between September and December 2022. Women aged 18\u201360 years living with HTLV-1 completed a 30-item instrument (29 closed-ended, one open-ended) assessing knowledge of HTLV-1 MTCT, attitudes toward pregnancy and breastfeeding, and related practices. Descriptive statistics were calculated, and free-text responses were thematically summarized. Of 45 survey entries, 43 unique responses were analyzed (median age 45 years [IQR 38-55.5]). Most participants resided in Metropolitan Lima (77%) and had access to water and sewage services (98%), limiting generalizability to higher-burden settings in Peru. Knowledge of HTLV-1 transmission was high: sexual transmission (95%), breastfeeding (93%), and blood transfusion (86%). Among women with children (N\u2009=\u200940), only nine had been diagnosed prior to any pregnancy; six recalled receiving breastfeeding counseling and adhered to recommendations (five exclusive formula, one breastfeeding &lt;6 months). Three women who formula-fed (3\/5, 60%) reported negative comments from relatives or friends. Thematic analysis (N\u2009=\u200937) identified six domains, including health-system limitations and stigma. Among care-engaged women in urban settings, knowledge and attitudes supportive of MTCT prevention were generally favorable; however, postpartum diagnosis emerged as the principal barrier for prevention. Targeted prenatal screening in high-risk groups, timely counseling, reliable access to breast-milk substitutes with safe water, provider training, and stigma mitigation strategies require evaluation in underserved and endemic settings.<\/jats:p>","DOI":"10.1371\/journal.pgph.0007103","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T17:31:36Z","timestamp":1787851896000},"page":"e0007103","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Women\u2019s knowledge, attitudes and practices related to mother-to-child transmission of HTLV-1 in Peru"],"prefix":"10.1371","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2411-0277","authenticated-orcid":true,"given":"Juan","family":"Macalupu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Ginocchio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9967-4093","authenticated-orcid":true,"given":"Alejandra","family":"Paiva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paloma","family":"Cusihuallpa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Rodr\u00edguez-Hurtado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8429-8833","authenticated-orcid":true,"given":"Fernando","family":"Mej\u00eda-Cordero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elsa","family":"Gonz\u00e1lez-Lagos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1747-4352","authenticated-orcid":true,"given":"Eduardo","family":"Gotuzzo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"issue":"1","key":"pgph.0007103.ref001","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/S1473-3099(19)30402-5","article-title":"Association 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