Recommendations for the Use of Antiretroviral Drugs in Pregnant Women with HIV Infection and Interventions to Reduce Perinatal HIV Transmission in the United States

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The information in the brief version is excerpted directly from the full-text guidelines. The brief version is a compilation of the tables and boxed recommendations.

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Counseling and Managing Women Living with HIV in the United States Who Desire to Breastfeed

Last Updated: December 24, 2019; Last Reviewed: December 24, 2019

Panel's Recommendations: Counseling and Managing Women Living with HIV in the United States Who Desire to Breastfeed
Panel's Recommendations
  • In the United States, the safest way to feed infants born to women with HIV is with formula, because breastfeeding presents an ongoing risk of HIV exposure after birth, and because suppressive maternal antiretroviral therapy significantly reduces, but does not eliminate, the risk of transmitting HIV through breastfeeding. Therefore, breastfeeding is not recommended for women living with HIV in the United States (AII).
  • Women who have questions about breastfeeding or who desire to breastfeed should receive patient-centered, evidence-based counseling on infant feeding options (AIII).
  • When women with HIV choose to breastfeed, they should be counseled to use harm-reduction measures to minimize the risk of HIV transmission to their infants (BIII).
Rating of Recommendations: A = Strong; B = Moderate; C = Optional

Rating of Evidence: I = One or more randomized trials with clinical outcomes and/or validated laboratory endpoints; II = One or more well-designed, nonrandomized trials or observational cohort studies with long-term clinical outcomes; III = Expert opinion

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