The delicate balance between breastfeeding's lifesaving benefits and the risk of HIV transmission complicates optimal infant feeding in communities affected by HIV. For this reason, counseling on infant feeding is one of the most important interventions to reduce mother-to-child transmission of HIV. LINKAGES endorsed a program approach to help women weigh the risks and benefits of different infant feeding options so they can choose and implement the one that is safest as well as acceptable, feasible, affordable, and sustainable for their situation.

National policy/advocacy, skills training, the strengthening of counseling, referral, and community support formed the foundation of LINKAGES' efforts to help in the prevention of mother-to-child transmission (PMTCT) of HIV. LINKAGES worked with partners within clinic and community-based maternal and child health services that also offer voluntary counseling and testing (VCT) and antiretrovirals (ARV) prophylaxis to pregnant women according to local health care protocols. At the regional and global level, LINKAGES:

• Provided technical assistance for the development of sound national policies on infant feeding and HIV
• Made presentations on infant feeding and HIV at numerous forums
• Used a risk analysis model developed by LINKAGES to estimate the risk of transmission through breastfeeding and the risk of death from artificial feeding
• Clarified a complex issue through various publications tailored to different audiences
• Documented and disseminated results of LINKAGES' PMTCT activities

Technical Information

• Breastfeeding and HIV/ AIDS- Frequently Asked Questions View Publication
• HIV and Infant Feeding: A Chronology of Research and Policy Advances and Their Implications for Programs View Publication
• HIV and Infant Feeding: Knowledge, Gaps and Challenges for the Future (powerpoint presentation) View Presentation
• Infant Feeding Options in the Context of HIV View Publication
• Prevention of Mother-to-Child Transmission of HIV in Asia: Practical Guidance for Programs View Publication
• Spotlight on Replacement Feeding: Transition to Replacement Feeding by HIV-Positive Women Who Breastfeed View Publication
• Spotlight on PMTCT: Reducing Mother-to-Child Transmission of HIV among Women who Breastfeed View Publication

Program Experience

• A Review of UNICEF Experience with the Distribution of Free Infant Formula for Infants of HIV-Infected Mothers in Africa View Publication
• Experience LINKAGES: Infant Feeding Assessments for PMTCT Program Design View Publication
• World LINKAGES Zambia View Publication
• Zambia Operations Research Final Report prepared by the Horizons Program View Publication

Tools

• A Spreadsheet Model to Estimate the Effects of Different Infant Feeding Strategies on Mother-to-Child Transmission of HIV and on Infant Mortality (used to calculate results reported in: Ross JS, Labbok MH. Modeling the effects of different infant feeding strategies on infant survival and mother-to-child transmission of HIV. Am J Pub Health 2004; 94:1175-1181.) (This is an interactive Microsoft Excel file - click here to view it.)
• Integrated Prevention of Mother-to-Child Transmission of HIV and Support for Infant Feeding: Community Motivators Course View Publication
• Integrated Prevention of Mother-to-Child Transmission of HIV and Support for Infant Feeding: Health Providers Course View Publication
• Nutrition Job Aids for Regions with High HIV Prevalence (developed in East Africa) View Publication
• Nutrition and HIV/AIDS: A Training Manual (developed by the Regional Centre for Quality of Health Care (RCQHC) in Uganda, FANTA, LINKAGES, and the SARA Project) For institutions of higher learning to improve the quality of training in nutrition and HIV/AIDS View Publication

Peer-Reviewed Publications

• Ross JS, Labbok MH. Modeling the Effects of Different Infant Feeding Strategies on Infant Survival and Mother-to-Child Transmission of HIV. Am J Pub Health 2004;94:1175-1181.
  View Abstract

• Piwoz E, Ross J. Use of population-specific infant mortality rates to inform policy decisions regarding HIV and infant feeding. Journal of Nutrition 2005;135:1113-1119.
  View Abstract