“They just assume everybody knows all the stuff”: infant feeding counseling needs among women with HIV in Philadelphia, United States

In 2023, the United States (U.S.) changed its national guidelines to restrict women living with human immunodeficiency virus (WWH) from breastfeeding, now supporting WWH in choosing this option under a collaborative decision-making model with health providers. Just prior to the implementation of the new guidelines, we conducted in-depth interviews with 28 WWH aged between 18 and 50 years who had previously given birth. We aimed to compose an understanding of infant feeding knowledge among WWH in our U.S. urban setting who had previously given birth and to understand the support women desire from their healthcare providers when given broader access to infant feeding choices. Three general categories of support need were highlighted. This included the need for: 1. information to raise awareness about breastfeeding as an option for WWH; 2. general guidance on infant feeding options; and 3. practical support to implement their choices. Knowledge gaps and misconceptions regarding HIV transmission and infant-feeding information were identified. This emphasizes the need for comprehensive infant feeding education and guidance among WWH to support the implementation of the current guidelines.