Problem: Vertical transmission of HIV via breast milk remains one of the biggest challenges in the global AIDS epidemic, particularly in developing countries where replacement feeding is often not feasible. With the advent of cheaper antiretroviral (ARV) therapy, much of the research done on this front has included the use of these drugs for both the mother and the child. Because these medications have proven fairly successful in decreasing transmission rates, the focus of most current research has revolved around determining the most efficacious regimens. The purpose of this literature review is to review the current interventions being researched, recommended and used to prevent the transmission of HIV via breast milk.
Methods: A PubMed search using online resources of the Weill Cornell Medical College Library, along with reading publications by the World Health Organization, UNICEF and UNAIDS, were done to determine the current research trends in HIV transmission via breast milk.
Results: All studies used in this review concluded that the use of ARV medications was successful in reducing transmission rates, but very few of the studies addressed the long-term consequences of wide-spread ARV use or alternatives to ARV therapy for the millions of women who have no access to ARVs.
Conclusions: ARV medications are a critical tool in preventing HIV transmission via breast milk in developing countries and determining the regimen that is most efficacious is important. Little is being done to find alternatives to ARV therapy, but one solution may be a nipple shield impregnated with sodium dodecyl sulfate that "kills" HIV in breast milk.