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August 25, 1999

When Is Breastfeeding Not Best?The Dilemma Facing HIV-Infected Women in Resource-Poor Settings

Author Affiliations

Author Affiliations: Maternal Child Transmission and Adolescent Studies Section, Epidemiology Branch, Division of HIV/AIDS Prevention—Surveillance/Epidemiology (Drs Fowler and Bertolli); National Center for HIV, STD, and TB Prevention, Office of the Director (Dr Nieburg), Centers for Disease Control and Prevention, Atlanta, Ga.

JAMA. 1999;282(8):781-783. doi:10.1001/jama.282.8.781

The successful implementation of the Pediatric AIDS Clinical Trials Group Protocol 076 (PACTG 076) zidovudine regimen for prevention of perinatal human immunodeficiency virus (HIV) transmission, in which HIV-infected women receive oral zidovudine during pregnancy, intravenous zidovudine during labor, and neonates receive 6 weeks of oral zidovudine, has led to dramatic reductions in pediatric acquired immunodeficiency syndrome (AIDS) in the United States and Europe.1,2 In stark contrast, health care workers in resource-poor settings such as sub-Saharan Africa struggle with 1600 new perinatal HIV infections daily3 and watch the increases in HIV-related infant mortality reverse the hard-won gains in child survival related to immunization, oral rehydration, and breastfeeding programs.

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