Infant feeding and HIV
UTHealth Houston researchers participate in CDC study
A shift in U.S health guidelines in early 2023 endorsed the option of breastfeeding/chestfeeding for some parents living with HIV, and researchers at UTHealth Houston are playing key roles in a national study to assess current practices and long-term outcomes.
Emily Barr, PhD, CPNP-PC, CNM, FACNM, FAAN, is a lead co-investigator on a study funded by the Centers for Disease Control and Prevention. The project, “Understanding Parental Lactation and Infant Feeding decisions Tailored to people with HIV in the United States (UPLIFT) (U01PS005288-01-00),” is led by principal investigator Lisa Abuogi, MD, MSc, an associate professor at the University of Colorado School of Medicine. Barr joined Cizik School of Nursing at UTHealth Houston as an assistant professor in 2022 from the University of Colorado, where she earned her PhD and had worked with parents with HIV as a pediatric nurse practitioner, and midwife, for two decades.
Researchers will collaborate with the International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT) Network to leverage well-established relationships with clinical sites, including Texas Children’s Hospital.
Until January 2023, parents with HIV were instructed not to breast/chestfeed their infants. However, research has shown that the transmission risk is less than 1 percent when the lactating parent is on antiretroviral therapy and has a fully suppressed viral load.
“I have been working my whole career with mothers and children with HIV, and I can’t count how many times I have had to sit with parents and tell them they cannot breastfeed without risking passing HIV to their infant. This was devastating for some families who really looked forward to breastfeeding,” said Barr, noting that many lactation consultants and health care providers are still not aware of the updated guidance from U.S. Department of Health and Human Services.
The UPLIFT study is the first national prospective study to examine infant feeding practices in people with HIV in the United States. The team will gather data on current practices and perceptions, recruit a cohort of pregnant and postpartum people with HIV at more than 10 sites across the U.S., and develop the first national, voluntary registry to build a database of longitudinal data from a diverse population of parents with HIV who choose to breastfeed/chestfeed.
“This study is the first of its kind, and I am honored to work with Dr. Abuogi and the Colorado team as well as several members of the Texas Development Center for AIDS Research,” said Barr, who will co-lead qualitative research and the prospective cohort, and lead the community engagement aspects of project.
Serving as lead statistician for the multistate study is Hulin Wu, PhD, a professor and chair of the Department of Biostatistics and Data Science at UTHealth Houston School of Public Health, with a joint appointment with McWilliams School of Biomedical Informatics. Other UTHealth team members include consultant and breastfeeding medicine specialist, Pamela Berens, MD, a professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at McGovern Medical School, and Mary Lingwall, MPH, BSN, a 2024 graduate of and current research coordinator at Cizik School of Nursing. Jennifer McKinney, MD, an assistant professor and maternal fetal medicine physician specializing in HIV care at Baylor College of Medicine, is also a consultant and protocol team member.
Also serving as a lead co-investigators are Christiana Smith-Anderson, MD, PhD, an associate professor of pediatrics-infectious diseases, and Karen Hampanda PhD, MPH, an assistant professor in the Center for Global Health, both from the University of Colorado.
