Preventing Maternal Transmission of HIV in Poor Nations

Doug Dix, Ph.D.

Professor of Biology and Medical Technology

Department of Health Science

University of Hartford

West Hartford, CT 06117


To establish justice, wealth must be redistributed from rich to poor. One means to this goal is for rich people to hire poor people to solve the problems of poverty. Maternal transmission of HIV is one such problem. Almost half of all such transmissions occur by breastfeeding (1). Formula-feeding would eliminate this risk, but is expensive, and, without refrigeration, dangerous. Poor mothers would be tempted to dilute formula with water placing their babies at risk of malnutrition and, because water is often polluted in poor countries, of infection. Without the benefits of breast-milk such infections would be particularly risky (2). Purchasing formula has the additional disadvantage of moving money from the poor to the rich. HIV-infected mothers, therefore, face a desperate dilemma: Breastfeed and risk infecting their babies with HIV, or formula-feed and risk malnutrition or dysentery.

Professional wet-nursing is an obvious solution (3-4). By hiring HIV-negative mothers to feed the babies of HIV-positive mothers, rich donors could provide the babies with optimal nutrition, and build female solidarity while enhancing female wealth, and inspiring girls to remain HIV-negative. There are some risks, however. The HIV-negative wet nurses would need to be tested frequently to insure that they remained free of HIV. And there is a risk that HIV-positive babies could transmit the virus to HIV-negative wet nurses. Until this risk is found to be insignificant or eliminated, wet-nursing should be reserved for HIV-negative babies.



1) Hoosen C. 2004, Antiretroviral agents – how best to protect infants from HIV and save their mothers from AIDS. New England Journal of Medicine 351: 289-92.

2) Cohen J. 2007, Hope on new AIDS drugs, but breast-feeding strategy backfires. Science 1357.

3) World Health Organization. 2004, HIV Transmission Through Breast Feeding: A Review of Available Evidence. 18: ISBN 92 4 156271 4,

4) Hinds J.,, Dixon T., Dix D. 2005, A strategy to minimize the impact of maternal HIV. Archives of Diseases of Childhood 90: 1319.


Reply to