Breastfeeding Defence Toolkit

Key policy documents and academic articles

Vertical HIV transmission should be excluded from criminal prosecution (2009)

Joanne Csete and colleagues argue that criminal laws on HIV transmission and exposure should be reviewed and revised to ensure that vertical transmission is explicitly excluded as an object of criminal prosecution. Scaling up PMTCT services and ensuring that they are affordable, accessible, welcoming and of good quality is the most effective strategy for reducing vertical transmission of HIV and should be the primary strategy in all countries.

The Threat Lives On: How to Exclude Expectant Mothers from Prosecution for Mere Exposure of HIV to their Fetuses and Infants (2015)

This article articulates how the threat of prosecution of mothers living with HIV who expose or transfer the virus to their foetuses or newborn will discourage and scare women away from seeking proper medical treatment instead of encouraging HIV treatment and prevention. It also explores how HIV-specific criminal transmission laws in the United States could hamper and stifle the progress in prevention and treatment of vertical transmission. It concludes by proposing a model for change in addressing these HIV-specific criminal transmission statutes.

WHO Guideline: Updates on HIV and Infant Feeding (2016)

The overall purpose of this guideline is to improve the HIV-free survival of HIV-exposed infants by providing guidance on appropriate infant feeding practices and use of ARV drugs for mothers living with HIV in countries with high HIV prevalence and settings in which diarrhoea, pneumonia and undernutrition are common causes of infant and child mortality.

The guideline addresses four aspects of infant feeding in the context of HIV:

  • the duration of breastfeeding by mothers living with HIV;
  • interventions to support infant feeding practices by mothers living with HIV;
  • what to advise when mothers living with HIV do not exclusively breastfeed; and
  • what to advise when mothers living with HIV do not plan to breastfeed for 12 months.

The guideline informs national policy-makers on what may be relevant for national policies and programmes, it provides guidance to health-care providers, researchers and clinicians involved in managing pregnant women and mothers living with HIV at various levels of health care.

Consolidated guideline on sexual and reproductive and rights of women living with HIV – Executive Summary (2017)

Executive summary from the World Health Organization’s Consolidated guideline on sexual and reproductive and rights of women living with HIV providing a summary list of WHO recommendations for the sexual and reproductive health and rights (SRHR) of women living with HIV and of good practice statements for the sexual and reproductive health and rights (SRHR) of women living with HIV.

Consolidated guideline on sexual and reproductive health and rights of women living with HIV (2017)

This guideline is meant to help countries to more effectively and efficiently plan develop and monitor programmes and services that promote gender equality and human rights and hence are more acceptable and appropriate for women living with HIV taking into account the national and local epidemiological context. It discusses implementation issues that health interventions and service delivery must address to achieve gender equality and support human rights.

It aims to provide evidence-based recommendations for the SRHR of women living with HIV in all of their diversity, with a particular focus on settings where the health system has limited capacity and resources; and good practice statements on key operational and service delivery issues that need to be addressed.

Alternative links
"Lignes directrices unifiées relatives à la santé et aux droits en matière de sexualité et de reproduction des femmes vivant avec le VIH" , "Сводное руководство по охране сексуального и репродуктивного здоровья и защите прав женщин, живущих с ВИЧ" , "Directrices consolidadas sobre la salud y los derechos sexuales y reproductivos de las mujeres que viven con VIH"

“Why Aren’t You Breastfeeding?”: How Mothers Living With HIV Talk About Infant Feeding in a “Breast Is Best” World (2015)

Infant feeding raises unique concerns for mothers living with HIV in Canada, where they are recommended to avoid breastfeeding yet live in a social context of “breast is best.” In narrative interviews with HIV-positive mothers from Ontario, Canada, a range of feelings regarding not breastfeeding was expressed, balancing feelings of loss and self-blame with the view of responsibility and “good mothering” under the current Canadian guidelines. Acknowledging responsibility to put their child’s health first, participants revealed that their choices were influenced by variations in social and cultural norms, messaging, and guidelines regarding breastfeeding across geographical contexts. This qualitative study raises key questions about the impact of breastfeeding messaging and guidelines for HIV-positive women in Canada.