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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
AIUM Credit
AIUM Credit
Foundation Awardee
Foundation Awardee
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Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 1

Category: Infectious Diseases

Poster Session 1

(318) Factors Associated with Infant Feeding Choice in People Living with HIV

Wednesday, February 11, 2026
10:30 AM - 12:00 PM  
Objective:
In January 2023, the U.S. Department of Health and Human Services revised its clinical guidelines from a recommendation against breastfeeding to an endorsement of patient-centered, shared decision-making regarding infant feeding in the context of maternal HIV infection. This study sought to characterize infant feeding decisions among pregnant PLWH following this update.

Study Design:
We evaluated breastfeeding rates among PLWH between 2023-2024 at a single academic tertiary medical center in the United States. Baseline characteristics and key perinatal outcomes were abstracted from electronic records and compared across patients who elected breastfeeding versus formula feeding. Mann-Whitney U test and Fisher’s Exact Test were used to compare continuous and categorical data, respectively. 


Results:
A total of 37 PLWH delivered between January 2023 and December 2024, of whom 7 elected to breastfeed (18.9%). Median duration of breastfeeding was 182 days (IQR 84.0, 188.5).  Compared to PLWH who chose formula, a higher proportion of breastfeeding PLWH had an undetectable viral load at first prenatal visit (86% vs 47%, p=0.10) and delivered vaginally (71% vs 37%, p=0.20). Among the 30 PLWH who formula fed, 13 (43%) were advised against breastfeeding due to clinical concerns, including suboptimal antiretroviral adherence (n=1) and detectable viral load during pregnancy (n=12). Other reasons for not breastfeeding included parental concerns about transmission (n=6), desire for shorter duration of infant post exposure prophylaxis (n=1), no interest (n=5), or infant given formula in first hour of life (n=1). There was no perinatal HIV transmission in this cohort.

Conclusion:
In this single institution study, approximately 1 in 6 PLWH chose to breastfeed. The predominant reason for formula feeding was parental and provider concern regarding HIV transmission. These findings suggest an urgent need for national data on lactation-associated HIV transmission among those with sustained viral suppression, as well as a need for evidenced-based tools to support shared-decision making regarding infant feeding among PLWH.