Breastfeeding and HIV-infected women in the United States: harm reduction counseling strategies.

Social and cultural forces have led some human immunodeficiency virus (HIV)-infected women to question the recommendation in the United States not to breastfeed. Without an open dialogue, women may choose to breastfeed exclusively or intermittently and not disclose this to their provider. We review the evidence from global studies of the risks of breastfeeding among HIV-infected mothers and propose a harm reduction model for women considering breastfeeding.