Changing The Guidelines Breastfeeding for Women Living With HIV in Australia Resource - PowerPoint Presentation

1. Changing The GuidelinesBreastfeeding for Women Living With HIV in Australia Resource 2021Written by: Heather EllisHeather Ellis – Communications and Engagement CoordinatorPositive Women Victoria

2. In Australia, prior to 2021, guidelines stated no breastfeeding for women living with HIV. Only formula feeding for infants.2015: The National Network of Women Living With HIV lobbied to revise guidelines based on latest scientific research. Network submission included a literature review of nearly 30 academic peer-reviewed scientific studies.2015 to 2020: No consensus reached despite a growing body of research showing transmission risk was extremely low.2020: Positive Women Victoria asked to write Breastfeeding For Women Living With HIV in Australia resource.History - changing the guidelines

3. Women living with HIV in Australia were breastfeeding behind closed doors and both healthcare providers and the HIV community were aware of this.Increased risk of HIV transmission as not supported and not aware of how risk is increased.Both HIV community advocates and some healthcare providers knew that supporting women was safer and guidelines had to be revised and a community resource published.History behind closed doors

4. ”We found out that the UK and several European countries had developed HIV Breastfeeding Guidelines supporting a mother’s choice to breastfeed”National Network of Women Living With HIV (Australia)

5. Resource for PLHIVGuidance for healthcare providersPublished September 2021

6. For settings such as Australia, boththe Resource (for PLHIV) and theGuidance (for clinicians and healthcare providers),advise the safest choice for a personliving with HIV and their infant isformula feeding. Formula still recommended as safest choice

7. Adapted from BHIVA breastfeeding guidelines (British HIV Association).Part of Living Well: Women with HIV –website (NAPWHA & AFAO). Developed under NAPWHAs HIV Health Literacy Framework project with funding support from ViiV Healthcare Australia.Produced as a shared collaboration between NAPWHA and Positive Women Victoria. Development

8. The Optimal Scenario: Breastfeeding is a viable choice for people living with HIV if they followed several criteria such as ARV treatment with a sustained undetectable viral load and engaged in strategies to reduce the risk of HIV transmission. Optimal Scenario’ on breastfeeding and HIV published in 2018 in the Swiss Medical Weekly.Optimal Scenario and Context of Care used to guide ASHM guidance on infant feeding options. Optimal Scenario

9. ASHM Guidance : The Optimal ScenarioASHM reviewed the latest research on HIV transmission through breastfeeding where the person was on effective ARV treatment and fulfilled several essential criteria and found no evidence of transmission of HIV. Scientific ResearchEvaluating the risksBreastfeeding Resource:In developing countries where studies have been conducted, the risk of HIV transmission via breastmilk when women are taking HIV medications is as low as 0.3% (PROMISE study) when babies were breastfed for six months. Not all mothers in these studies had sustained durable viral suppression while taking HIV medications. 

10. Ask to be included in research

11. U=U and Breastfeeding

12. First draft of the Resource was shared with women living with HIV who were mothers, had previously breastfeed, were pregnant or had recently given birth. Several feedback sessions via zoom.Feedback incorporated into second draft.“This gives me confidence to breastfeed my baby, but there is still so much opposition from doctors.” HIV Focus Group Consulation

13. Contents –Key highlights

14. Contents –Key highlights

15. Breastfeeding for Women Living with HIV online community forum

16. Download at: www.positivewomen.org.au/pregnancy-breastfeeding/ 

17. “Finally, woman living with HIV in Australia have access to both a practical guide and a helpful resource  that both take on the real challenges when considering such an emotive issue as breast and formula feeding options.Both offer balanced information that will not only empower and support women to safely consider their options but helps remove that stigma and guilt”.Katherine Leane, President Positive Life South Australia 2021, member of the National Network of Women Living With HIV, HIV Positive Women and Mother of 35 years 

18. AcknowledgementsWritten by: Heather Ellis, Positive Women VictoriaEditorial team:Dr Kirsty Machon, Positive Women VictoriaAdrian Ogier, NAPWHA, Saysana Sirimanotham, NAPWHAWith thanks to:Brent Allan ICASOKate Bath, ASHMKatherine Leane, Community AdvocateSarah Feagan, Community AdvocateLara Kruizinga, Community AdvocateEmma Sheldon Collins, Community AdvocateMelania Mugamu, Queensland Positive PeopleAbbie Opuama, Queensland Positive PeopleDaniel Reeders, NAPWHANational Network of Women Living with HIVPositive Women Victoria focus group participants

19. AcknowledgementsKate Bath | Katherine Leane | Heather Ellis | Vanessa Gonzalez | Teddy Cook Scott McGill | Jessica Whitbread | Katy Roy | Krista Martel | Liz CrockSaysana Sirimanotham | Joshua Badge | Jacqueline Rodvang | May WangMona Loufty | Michelle Giles Written by: Brent Allan and Dr Kirsty Machon (EO Positive Women Victoria)Reviewed by: ASHM HIV Board-Sub Committee, the ARVGuidelines Committee and the Breastfeeding Guidance Committeewith additional feedback from the Australian and New ZealandPaediatric Infectious Diseases Group.Special thanks to: Virginia Furner, Pamela Palasanthiran and Fiona Bisshop for their support, guidance and advocacy in bringing this version of the guidance to fruition.

20. Download at: www.positivewomen.org.au/pregnancy-breastfeeding/