Factors influencing counseling on infant feeding options: a qualitative study with women living with HIV and their healthcare professionals in a high-income setting

This qualitative study explores factors influencing counseling on infant feeding options for women living with HIV in a high-income setting. Semi-structured interviews were conducted with twenty healthcare professionals from perinatal HIV teams and eleven women living with HIV to identify barriers and facilitators in the decision-making processes. The findings indicate that the absence of local protocols results in uncertainty and inconsistency in counseling, while both professionals and women emphasize the need for a clear division of responsibilities and up-to-date information tailored to current clinical guidelines. National recommendations are often insufficiently adapted to cultural context and have a paternalistic tone, contributing to anxiety and confusion. The study highlights the importance of expert support as well as accessible, clear communication strategies, including the development of an informative website and the involvement of women living with HIV in creating such educational materials. A systemic approach, engaging all stakeholders, is considered essential to foster both empowerment and trust. Optimal implementation of updated guidelines requires attention to these factors to ensure that women living with HIV can make fully informed and autonomous choices regarding breastfeeding or formula feeding for their children.