Tatum Le

A panel of advocates, service providers and global health practitioners from Africa, Australia and the USA shared their experiences around the remaining barriers and struggles related to breastfeeding for people living with HIV.

In 2010, the World Health Organization issued new guidelines on HIV and infant feeding, including guidance on the option of breastfeeding. Heather Ellis, Coordinator at Positive Women Victoria (Australia), presented on how women living with HIV succeeded in changing guidelines for breastfeeding in Australia, which now recognize that “breastfeeding can be a viable choice for [people living with HIV] if they follow several criteria and are willing to engage in strategies to reduce the risk of HIV transmission.” Ciarra Covin from the Well Project (USA) reflected on her journey as a woman living with HIV having experienced the anguish of being unable to breastfeed her first child. She described how people living with HIV need partners in the healthcare system, not investigators. Nyasha Chingore from AIDS and Rights Alliance for Southern Africa (Zimbabwe) noted that “despite the fact that the guidelines in southern Africa appear to be supportive of breastfeeding, many women living with HIV have faced criminal prosecution for breastfeeding.” “The only harm that we [are] seeking to reduce [is] the harm of HIV, while completely neglecting the management of risks and benefits of all things,” noted Marielle Gross, physician and professor at the University of Pittsburgh (USA).

Through this session, the diverse group of panelists provided a succinct and clear message around the need for holistic and evidence-based policies and guidelines for women (cis and trans), trans men and non-binary people living with HIV who seek to breastfeed. Although more data on HIV and breastfeeding is needed, providers and policy-makers should also use the data that is already available to help inform the current approach to engaging with people living with HIV who wish to breastfeed.