Duration of breast feeding in the general population | Treatment | Mixed breast feeding | Replacement feeding | Exclusive breast feeding |
Approximately 6 months | None | 26 | 20 | 23 |
Single-dose nevirapine | 17 | 11 | 14 | |
Dual-prevention ARV | 10 | 4 | 7 | |
Triple-treatment ARV | 4 | 2 | 3 | |
Approximately 12 months | None | 30.5 | ||
Single-dose nevirapine | 21.5 | |||
Dual-prevention ARV | 14.5 | |||
Triple-treatment ARV | 5 | |||
Approximately 18 months | None | 35 | ||
Single-dose nevirapine | 26 | |||
Dual-prevention ARV | 19 | |||
Triple-treatment ARV | 6 |
Mixed breast feeding: in addition to replacement feeding rates
First six months: 1% per month for first 6 months (total 6%) (based on reports by Iliff et al45 and Rollins46: approximately double the hazard of exclusive breastfeeding).
Thereafter: 0.75% per month for next 6 months (total 4.5%) and for next 6 months (total 4.5%) (based on BHITS meta-analysis47: 8.9% per 100 person-years).
Triple-treatment ARV: in absence of data, assume 2% additional transmission for first 6 months, then 1% for next 6 months and again 1% for next 6 months.
Replacement feeding
No treatment: 20%: based on 2004 UNICEF/UNAIDS/WHO/UNFPA review.40
Single-dose nevirapine: based on data from Jackson et al (11.8% at 6–8 weeks in breastfeeding population)41 and Moodley et al (10.7% among replacement feeding population).42
Dual-prevention ARV: based on Ditrame (6.5% at 6 weeks (with some breastfeeding transmission))43 and PPHT-2 (1.9–2.8% among replacement feeding population).44
Triple-treatment ARV: based on western studies quoted in report by UNICEF/UNAIDS/WHO/UNFPA.40
Exclusive breast feeding
In addition to replacement breastfeeding rates: 0.5% additional transmission per month (total 3%) (based on reports by Iliff et al45 and Rollins46).
Triple-treatment ARV: in absence of data, assume 1% additional transmission.