HIV faith involves believing that "exclusive" breastfeeding should be promoted in "low-resource" settings (countries like Africa). And more recently studies are showing that abrupt cessation of breastfeeding does not improve survival of those infants of hiv-positive mothers. (New England Journal of Medicine, July 10, 2008-"Effects of Early, Abrupt Weaning on HIV-free Survival of Children in Zambia.") But in resource-rich countries like the USA, breastfeeding by hiv-positive mothers is discouraged. The word discouraged does not actually describe what is said to hiv mothers in the USA. Thus world policy on hiv and breastfeeding is like a forked tongue. Dependent on where you live, you will either be encouraged or discouraged to breastfeed. From the standpoint of a poor, under-educated hiv-positive woman who lives in a resource poor country and is being told to breastfeed, the policy makes little sense. Infant formula is the unattainable food that will save her infant. But she is denied this commodity because of her poverty. For the educated, hiv-positive woman in a resource rich country, breastfeeding is the value. But she is denied it because of her wealth. The policy is based on faith in HIV testing and its reliability. Policy is based on studies that did not define breastfeeding, and on on hiv tests that are no longer used to determine hiv status of infants.
One aspect of this policy is the belief that all women in the USA benefit from our resource-rich nation, all have access to excellent medical care. If infant mortality rates tell a story about the health of a nation, the story here in the US, would be a tale of two cities. The cities of the white and the wealthy with ease of access to medical care. And the cities of the poor, mostly non-white with little medical care and few resources. In Washington, DC in 2005 the black infant mortality rate in Ward 8 is 21.7 deaths per 1000 live births. In counties in Florida in 2006, the white infant mortality rate ranges from 3.4 to 6.9 and the nonwhite infant mortality rate is anywhere from 6.4 to 55.5. Cuba has an infant mortality rate of 5.9 (currentCIA statistics). Zimbabwe has an infant mortality rate of 50.58, Haiti 48.8, Vietnam 19.5, India 55.0. With such a racial divided infant mortality rate in the USA, why is that we believe that only poor hiv-positive women in Africa should breastfeed? Not one infant in 2006 in my county died of hiv (there was no AIDS category) but many infants died of pneumonia, septicemia, diarrhea, gastrointestinal and respiratory illness, SIDS. We will spend milions/billions on testing for hiv/aids. And companies like OraSure will ring the opening bell of the NASDAQ year after year.
Copyright 2008 Valerie W. McClain