Women's Beliefs About Breastfeeding and Transmission of AIDS in Rural Côte d'Ivoire

To the Editor: Despite the significant progress in prevention of the vertical transmission of human immunodeficiency virus (HIV) in industrialized countries, including perinatal antiviral drugs, little progress has been made in developing countries, especially in sub-Saharan Africa. However, recent studies suggested that multivitamin supplementation might be a feasible and cost-effective approach to reduce the risk of vertical transmission as well as progression of HIV, although ongoing clinical trials should be awaited to ensure its efficacy.¹ Another potential strategy is avoiding breastfeeding. Breast milk is an important source of mother-to-child transmission, which is estimated to be responsible for one third to half of mother-to-child transmission worldwide.² A recent study showed that an estimated risk of late postnatal transmission was 3.2 per 100 child-years of breastfeeding follow-up.³ In Côte d'Ivoire, which has one of the highest HIV prevalence rates (more than 10%),⁴ stopping breastfeeding at 6 months is already being considered for women infected with HIV.⁵