Human Immunodeficiency Virus
Conditions
Keywords
Human Immunodeficiency Virus
Brief summary
The PACIFY Study is a questionnaire for antenatal(third trimester) and postnatal(three months post delivery) Human Immunodeficiency Virus (HIV) positive women attending clinics in London and Brighton. The current World Health Organisation guidance advises HIV positive women, who are adhering to antiretroviral therapy (ART), to exclusively breastfeed for the first 6 months of the infant's life and continue supplemental breastfeeding for up to 2 years. This is conflicts with the current British HIV Association guidelines which advise exclusive formula feeding. The reason for this difference is the relative safety of formula feeding in the United Kingdom(UK)against the low but persisting risk of HIV infection through breast-feeding. The aim of the PACIFY study is to explore attitudes towards breastfeeding amongst HIV positive women, who are either pregnant or post-partum. The study will also assess the understanding of current infant feeding guidance by these women and assess their current or recent infant feeding practice. It will also look at whether HIV positive mothers would be willing and able to comply with special monitoring and guidance whilst breastfeeding if the guidelines were to change. The study aims to analyse 100 questionnaires completed over a 3-6 month period.
Detailed description
All eligible female patients (currently or recently pregnant) attending routine HIV-related appointments will be invited to participate and a participant information sheet will be given. Those who have consented to join the study will be given a short questionnaire to complete and return during that attendance. The questionnaire takes about 15 minutes to complete. The option of returning the questionnaire by post will be available but not encouraged. During the collection period, women with HIV attending either antenatal (third trimester) or postnatal (within three months of delivery) care will be eligible to participate, but they will only be asked once, either before or after delivery. Ideally equivalent numbers of pre and postnatal participants will be enrolled. Participants given a questionnaire and have a centre and unique study number. Maternal cluster of differentiation 4 (CD4) count and HIV Viral load nearest to time of questionnaire completion will be recorded if patient consents. Participants will be able to place their completed paper questionnaires in a sealed envelope in a box in the clinic.Participants will be informed that their questionnaire responses will not be seen by clinical staff (unless participants request staff support in completion of the questionnaire) or recorded in their clinical notes. In the clinics the study log will be the only document linking study number with hospital identification (ID)number and soundex. Completed questionnaires will be stored securely in local sites prior to transfer to St Mary's Hospital (by the study team). The study log will be maintained securely along with the delegation log by the site lead investigator.
Interventions
OTHERQuestionnaire
Patients will be asked to complete one off questionnaire.
Sponsors
Imperial College London
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
* Age \> 18 years * Able to give written informed consent * Post-natal and antenatal HIV positive women
Exclusion criteria
* Age \<18 years * Patients who are unable to consent. * Women with HIV who have not been pregnant.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Knowledge and Experiences of Breastfeeding Among Women Living With HIV | At their pre-or postnatal outpatient appointment, an average of one day | Participants were recruited by clinicians from 12 HIV clinics across England (South East, West Midlands and West Yorkshire) between June 2017 and June 2018. Participants were given the study patient information leaflet and consent form when they attended their regular pre- or postnatal outpatient appointment and, if they agreed to participate, they completed the anonymised questionnaire (Supplemental Appendix X) during the same visit. All the questionnaires were collated at Imperial College Healthcare NHS Trust. In the data table, breastfeeding has been abbreviated to BF. |
| Views on Infant Feeding for Women Living With HIV | At their pre-or postnatal outpatient appointment, an average of one day | The PACIFY study (Positive Attitudes Concerning Infant Feeding) sought to explore the views, concerns and issues surrounding breastfeeding in women living with HIV (WLHs). Questions within the questionnaire: 1. If you did not have HIV, would you breastfeed your child? 2. Living with HIV, would you like to breastfeed your child? |
Countries
United Kingdom
Participant flow
Recruitment details
Patient were recruited from medical outpatient clinics across England The study period was May 2017 -May 2018
Participants by arm
| Arm | Count |
|---|---|
| Women Living With HIV The PACIFY was a descriptive questionnaire with no study arms Patients were recruited from 12 clinics in England.Participant were asked to complete a six paged questionnaire which would be analysed. | 94 |
| Total | 94 |
Baseline characteristics
| Characteristic | Women Living With HIV |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 0 Participants |
| Age, Categorical Between 18 and 65 years | 94 Participants |
| Education status Higher education | 77 Participants |
| Education status No answer | 1 Participants |
| Education status Primary school | 3 Participants |
| Education status Secondary school | 13 Participants |
| Employment status Employed | 51 Participants |
| Employment status Unemployed | 43 Participants |
| HIV diagnosed Before pregnancy | 71 Participants |
| HIV diagnosed During current pregnancy | 23 Participants |
| HIV parameters HIV viral load <50 copies/ml | 86 Participants |
| HIV parameters HIV viral load >50 copies/ml | 1 Participants |
| HIV parameters No answer | 7 Participants |
| Immigration Immigrants | 70 Participants |
| Immigration No answer | 6 Participants |
| Immigration Non-immigrants | 18 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 9 Participants |
| Race (NIH/OMB) Black or African American | 72 Participants |
| Race (NIH/OMB) More than one race | 3 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) White | 10 Participants |
| Sex: Female, Male Female | 94 Participants |
| Sex: Female, Male Male | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 94 |
| other Total, other adverse events | 0 / 94 |
| serious Total, serious adverse events | 0 / 94 |
Outcome results
Primary
Knowledge and Experiences of Breastfeeding Among Women Living With HIV
Participants were recruited by clinicians from 12 HIV clinics across England (South East, West Midlands and West Yorkshire) between June 2017 and June 2018. Participants were given the study patient information leaflet and consent form when they attended their regular pre- or postnatal outpatient appointment and, if they agreed to participate, they completed the anonymised questionnaire (Supplemental Appendix X) during the same visit. All the questionnaires were collated at Imperial College Healthcare NHS Trust. In the data table, breastfeeding has been abbreviated to BF.
Time frame: At their pre-or postnatal outpatient appointment, an average of one day
| Arm | Measure | Group | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|---|
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Have any friends, family or community members questioned you about your reasons for not BF? | Yes | 58 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Have any friends, family or community members questioned you about your reasons for not BF? | No | 25 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Have any friends, family or community members questioned you about your reasons for not BF? | Don't know | 0 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Have any friends, family or community members questioned you about your reasons for not BF? | No answer | 11 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Have you ever had to lie about your reasons for not BF? | Yes | 62 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Have you ever had to lie about your reasons for not BF? | No | 21 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Have you ever had to lie about your reasons for not BF? | Don't know | 0 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Have you ever had to lie about your reasons for not BF? | No answer | 11 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | If you did not have HIV, would you BF your child? | Yes | 84 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | If you did not have HIV, would you BF your child? | No | 2 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | If you did not have HIV, would you BF your child? | Don't know | 8 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | If you did not have HIV, would you BF your child? | No answer | 0 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Living with HIV, would you like to BF your child? | Yes | 36 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Living with HIV, would you like to BF your child? | No | 45 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Living with HIV, would you like to BF your child? | Don't know | 6 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Living with HIV, would you like to BF your child? | No answer | 7 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Do you think it's safe for women with detectable HIV in the blood to BF? | Yes | 3 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Do you think it's safe for women with detectable HIV in the blood to BF? | No | 63 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Do you think it's safe for women with detectable HIV in the blood to BF? | Don't know | 22 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Do you think it's safe for women with detectable HIV in the blood to BF? | No answer | 6 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Do you think it's safe for women on treatment with fully suppressed HIV to BF? | Yes | 26 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Do you think it's safe for women on treatment with fully suppressed HIV to BF? | No | 33 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Do you think it's safe for women on treatment with fully suppressed HIV to BF? | Don't know | 31 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Do you think it's safe for women on treatment with fully suppressed HIV to BF? | No answer | 4 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | If you were to BF, would you have monthly blood tests to check your viral load stays undetectable? | Yes | 83 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | If you were to BF, would you have monthly blood tests to check your viral load stays undetectable? | No | 10 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | If you were to BF, would you have monthly blood tests to check your viral load stays undetectable? | Don't know | 0 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | If you were to BF, would you have monthly blood tests to check your viral load stays undetectable? | No answer | 1 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | If you were to BF, would you be willing for your baby to have a monthly HIV blood test? | Yes | 79 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | If you were to BF, would you be willing for your baby to have a monthly HIV blood test? | No | 13 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | If you were to BF, would you be willing for your baby to have a monthly HIV blood test? | Don't know | 0 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | If you were to BF, would you be willing for your baby to have a monthly HIV blood test? | No answer | 2 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Do you have any concerns about BF while you are taking anti-HIV medicines? | Yes | 47 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Do you have any concerns about BF while you are taking anti-HIV medicines? | No | 44 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Do you have any concerns about BF while you are taking anti-HIV medicines? | Don't know | 1 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Do you have any concerns about BF while you are taking anti-HIV medicines? | No answer | 2 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Have you heard of 'exclusive BF' (giving the baby breast milk only and no other feeds or drinks)? | Yes | 63 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Have you heard of 'exclusive BF' (giving the baby breast milk only and no other feeds or drinks)? | No | 29 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Have you heard of 'exclusive BF' (giving the baby breast milk only and no other feeds or drinks)? | Don't know | 0 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Have you heard of 'exclusive BF' (giving the baby breast milk only and no other feeds or drinks)? | No answer | 2 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | If you were to BF, would you be happy to exclusively BF? | Yes | 51 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | If you were to BF, would you be happy to exclusively BF? | No | 41 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | If you were to BF, would you be happy to exclusively BF? | Don't know | 0 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | If you were to BF, would you be happy to exclusively BF? | No answer | 2 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Have any healthcare workers discussed BF with you? | Yes | 84 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Have any healthcare workers discussed BF with you? | No | 8 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Have any healthcare workers discussed BF with you? | Don't know | 0 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Have any healthcare workers discussed BF with you? | No answer | 2 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Would you like more information on the benefits and disadvantages of BF? | Yes | 45 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Would you like more information on the benefits and disadvantages of BF? | No | 48 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Would you like more information on the benefits and disadvantages of BF? | Don't know | 0 Participants |
| Women Living With HIV | Knowledge and Experiences of Breastfeeding Among Women Living With HIV | Would you like more information on the benefits and disadvantages of BF? | No answer | 1 Participants |
Primary
Views on Infant Feeding for Women Living With HIV
The PACIFY study (Positive Attitudes Concerning Infant Feeding) sought to explore the views, concerns and issues surrounding breastfeeding in women living with HIV (WLHs). Questions within the questionnaire: 1. If you did not have HIV, would you breastfeed your child? 2. Living with HIV, would you like to breastfeed your child?
Time frame: At their pre-or postnatal outpatient appointment, an average of one day
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Women Living With HIV | Views on Infant Feeding for Women Living With HIV | would like to breastfeed if they were HIV negative | 89 percentage of total participants |
| Women Living With HIV | Views on Infant Feeding for Women Living With HIV | would like to breastfeed while living with HIV | 38 percentage of total participants |