The Well Project Survey Reveals Dramatic Shift in Provider Support of Breast/Chestfeeding After 2023 HIV Guideline Updates
Posted September 5, 2024From The Well Project:
Groundbreaking infant-feeding updates in the US Perinatal HIV Clinical Guidelines have led healthcare providers to report significantly increased support for women and other birthing parents living with HIV who are interested in breast/chestfeeding. In a survey conducted by The Well Project, 82 percent of healthcare providers indicated they were “mostly/very supportive” of breast/chestfeeding for parents living with HIV after the 2023 guideline updates, compared to just 32 percent retrospectively indicating such support prior to the updates.
Since 2018, The Well Project has been actively driving advocacy efforts, conducting needs assessments, and producing accessible, evidence-based resources to support parents living with HIV in their infant-feeding decision-making. In late 2021, The Well Project launched BEEEBAH (Building Equity, Ethics, and Education on Breastfeeding and HIV) – a comprehensive, multi-tiered project that encompasses the organization’s work in this area.
In January 2023, the US Department of Health and Human Services (HHS) issued broad updates to the “Infant Feeding for Individuals with HIV in the United States” section of their Perinatal HIV Clinical Guidelines. The updates clarify HIV transmission rates through breast milk (less than 1 percent if the lactating parent has an undetectable viral load and is taking HIV medications); discuss important social, emotional, nutritional, disease-prevention, and other benefits of breastfeeding to parents and babies; and assert the need for shared decision-making and increased support from providers around parents’ infant-feeding choices. The American Academy of Pediatrics followed with similar updates in May 2024. These modifications represent a notable accomplishment for advocates, including The Well Project, who worked on various levels for several years to effect these changes.
Through BEEEBAH programming, The Well Project conducted the 2024 Infant Feeding and HIV Survey to help measure stakeholder knowledge and attitudes, as well as the impact of the HHS guidelines update. The survey is a follow-up to a baseline knowledge survey disseminated in fall 2022 (prior to guideline updates).
The Well Project developed both surveys in partnership with ETR, a non-profit organization providing science-based training, evaluation, and other services to improve health equity. The 2024 survey was administered online via the SurveyMonkey platform in February and March 2024 and closed with 226 complete responses. While the survey was shared to broad networks, its main audience was healthcare providers (n = 117, or 52 percent of respondents) serving people living with HIV. Respondents also identified their roles as working in an organization that supports people living with HIV (39 percent), public health professional (27 percent), and person living with HIV (22 percent).
