Association of Nurses in AIDS Care Position on Breastfeeding and Chestfeeding: Ensuring Equity, Autonomy, Access, and Respect in HIV-Related Infant Feeding Decisions

Abstract – People with HIV (PWH) have the right to make informed, supported decisions about infant feeding, including breastfeeding or chestfeeding. This position statement from the ANAC affirms the importance of access, equity, autonomy, and respect in lactation counseling and care. Evidence-based clinical guidelines now support shared decision making for PWH on antiretroviral therapy with sustained viral suppression, with studies showing a transmission risk of less than 1% through human milk. Despite this, stigma, inconsistent provider messaging, and punitive threats persist, particularly for marginalized communities. ANAC calls for a harm reduction approach rooted in relational decision making and nonjudgmental, evidence-based support. The statement includes recommendations for education, policy reform, and implementation research to improve care delivery. Nurses and clinicians have a central role in creating inclusive, supportive environments that honor reproductive justice and the lived experiences of families navigating infant feeding with HIV.