15th International AIDS Conference Bangkok, Thailand — July 11-July 16, 2004

Int Conf AIDS. 2004 Jul 11-16;15:Abstract No. LbOrB11

C Covington¹, M Abdullah², A Omar³, R Nduati⁴, A Roberts^1
1University of California, Los Angeles, United States; ²Aga Khan Medical Center, Nairobi, Kenya; ³Malindi Hospital District, Malindi, Kenya; ⁴University of Nairobi, Nairobi, Kenya

BACKGROUND: The majority of global pediatric AIDS cases are attributed to mother-to-child transmission via birth and breastfeeding processes. Yet breastfeeding remains the primary source of infant nutrition, as formula is neither an affordable nor a safe option. To avoid pediatric AIDS, novel, cost-efficient technology is needed to feed infants safely. The primary study aim was: 1) determine if HIV- grandmother (GM) age women could re-establish a nutritious and adequate milk supply equivalent in essential nutrient bioavailability to mother's milk in coastal Kenya; and 2) assess the community acceptance of surrogate feeding of infants by elder HIV- relatives when the birth mother is HIV+.

METHODS: GMs and their postpartum, breastfeeding daughter (DGT) were recruited (N=25 GM; 25 DGT). A manual breast pump was used 4 times a day for 10 minutes over 6 weeks to stimulate re-lactation. GM breast milk and serum samples were collected at the end of 6 weeks. DGTs supplied a one-time donated breast milk sample for bio-equivalence comparison. Aim 2 was addressed by focus group and individual interviews of the villagers, and with chiefs and community leaders.

RESULTS: Data revealed that GM re-lactated milk compared favorably to that from donor DGTs. GM samples contained secretory IgA and proteins of breast milk, leukocytes, fatty acids and other nutritional components at levels similar to DGT's samples. The interview data suggests that GM surrogate feeding was highly acceptable to the informants. The community proposed that grandparents be tested prior to the expected child's birth for HIV and a contract be drawn to promote HIV-free surrogate nursing. The role of the chief and child advocate to oversee this family contract was strongly urged.

CONCLUSION: This study holds promise to build a culturally-tailored repertoire of feeding technologies that address the burgeoning HIV/AIDS pandemic in Africa and other developing nations by blending traditional and modern knowledge.

040711
LbOrB11

Copyright © 2004 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.