Background: Partners In Health (PIH) works with the Ministry of Health to provide comprehensive health services\r\nin Haiti. Between 1994 and 2009, PIH recommended exclusive formula feeding in the prevention of mother-tochild\r\ntransmission (PMTCT) of HIV program and provided support to implement this strategy. We conducted this\r\nstudy to assess HIV-free survival and prevalence of diarrhea and malnutrition among infants in our PMTCT program\r\nin rural Haiti where exclusive formula feeding was supported.\r\nMethods: We reviewed medical charts of PMTCT mother-infant pairs at PIH between November 2004 and August\r\n2006 through a retrospective longitudinal study and cross-sectional survey. We performed household surveys for\r\neach pair and at control households matched by infant�s age and gender.\r\nResults: 254 mother-infant pairs were included. 15.3% of infants were low birth weight; most births occurred at\r\nhome (68.8%). 55.9% of households had no latrine; food insecurity was high (mean score of 18; scale 0-27, SD =\r\n5.3). HIV-free survival at 18 months was 90.6%. Within the cohort, 9 children (3.5%) were HIV-infected and 17 (6.7%)\r\ndied. Community controls were more likely to be breastfed (P = 0.003) and more likely to introduce food early (P =\r\n0.003) than PMTCT-program households. There was no difference in moderate malnutrition (Z score = 2 SD)\r\nbetween PMTCT and community groups after controlling for guardian�s education, marital status, and food\r\ninsecurity (OR = 1.05; 95% CI: 0.67, 1.64; P = 0.84). Diarrhea was 2.9 times more prevalent among community\r\nchildren than PMTCT infants (30.3% vs. 12.2%; P < 0.0001).\r\nConclusions: In a PIH-supported program in rural Haiti that addressed socioeconomic barriers to ill-health, breast\r\nmilk substitution was safe, acceptable and feasible for PMTCT for HIV-infected women choosing this option.
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