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>Date:    Fri, 23 Aug 2002 07:08:39 -0600
>From:    Jodine Chase <[log in to unmask]>
>Subject: HIV/milk news analysis
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>
>http://www.redflagsweekly.com/Thursday_report/2002_august22.html
>
> > August 22, 2002
> >
> > America : The Land of HIV-Free Milk and Honey
> >
> > Results of New Study Say "Let HIV+ Mothers Care for Their Babies"
> >
> > By Cory Mermer
> > RFW Associate Editor
> >
> > Breastfeeding can save your baby¹s life and should be practiced if at all
> > possibleŠBreastfeeding is too dangerous and MUST be avoided at all costs.
> >
> > The above statements are quite obviously diametrically opposed to one 
> another.
> > Yet these two statements represent the advice currently given to 
> mothers who
> > test positive for HIV, the virus widely reported to be responsible for the
> > AIDS epidemic.
> >
> > How is this possible? The answer is simple. It depends on your address, of
> > course!
> >
> > If that doesn¹t make much sense to you, then GOODŠyou are among the 
> seemingly
> > small number of people with the ability to think for yourself!
>
><snip>
>
>The article above appears on the health news analysis site Red Flag Weekly.
>The conclusion is that perhaps women in third world countries are getting
>better advice than women in North America.
>
>-- Jodine Chase
I have conducted a study on counsellors' perspective and knowledge on 
MTCT-issues. This article is called "Counsellors’ Perspectives on Antenatal 
HIV-Testing and Infant Feeding Dilemmas Facing HIV-Infected Women in 
Northern Tanzania" which is to be published in
Reproductive Health Matters 2002;10(20):XXX-XXX.  I don't believe that the 
conclusion that women in third world countries are getting better advice 
than their North American counterparts is correct.
We found that informed choice of infant feeding method by HIV-infected 
women, as recommended by UNAIDS/WHO/UNICEF Guidelines, was seriously 
compromised by the actual advice given, directive counselling, lack of time 
to cope with a positive HIV test result, and lack of follow-up support, 
regardless of socioeconomic status. Infant feeding options were not always 
accurately explained, but counsellors believed most women had little choice 
but to breastfeed and were unlikely to exclusively breastfeed, despite 
advice. It was apparent that the risks and benefits of the options open to 
HIV-infected women were complicated for the counsellors, not only the 
women. We concluded that counsellors needed additional training in 
non-directive counselling and infant feeding options to ensure quality 
advice-giving and support to follow-up women at home.

Marina Manuela de Paoli, Norway

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