Reducing new HIV infections has been a priority in the UK ever since the epidemic’s outbreak. It’s taken so seriously the vast majority of ways to prevent infection are free to those who need them. Condoms and lube can be accessed for free, people who inject drugs should have access to free injecting equipment through Needle and Syringe Programmes, and people can begin HIV treatment (also free) immediately if this reduces their risk of passing on HIV to others. These methods have and will continue to contribute to the UK’s relatively successful response to the epidemic.
Yet for mothers living with HIV looking to reduce the risk of passing on HIV to their baby after birth there is one key prevention method they do not have a right to access for free: formula milk. On International Women’s Day we want to take the opportunity to highlight this unmet need.
Breastfeeding carries a risk of passing on HIV to an infant and although the risk is low when a mother is on treatment, the long-term effects of exposing an infant to HIV treatment via breastmilk are unknown. This has led the British HIV Association to consistently recommend that in the UK infants born to HIV positive mothers should only be formula fed apart from in exceptional circumstances.
So when condoms and syringes are given out for free why is formula milk not? Without a policy in place we risk some mothers having to choose between feeding themselves and protecting their child from HIV. We risk reducing the strides we’ve made towards eliminating mother to child transmission. And we risk creating an inequality when it comes to HIV prevention – some people we will help to stay HIV negative and others we won’t.
We know some mothers are struggling or failing to meet the cost of formula feeding their babies.
Without a policy allowing all mothers living with HIV to access free formula, mothers are relying on a patch-work of free formula schemes. These vary in terms of who can access them, how formula is provided, and for how long. Whilst we should commend the existence of these schemes and the dedication of those who have championed them, they do not go far enough to address the need.
It is the duty of our health system to support people to prevent them passing on HIV to others – and to break down some of the barriers that might stop them accessing key prevention methods.
On International Women’s day it’s therefore worth remembering that whilst the UK has achieved impressively low rates of mother-to-child transmission of HIV, more can and should be done to remove the financial burden on mothers living with HIV. Formula feeding practically eliminates the risk of HIV transmission to babies after pregnancy. In the absence of a policy enabling all mothers living with HIV to access it for free, we are wrongly denying mothers easy access to prevention methods and, as a country, we are missing a ‘formula for success’ in preventing future mother-to-child infections.