Breastfeeding Experience Among Women Living With HIV: A Global Qualitative Evidence Synthesis

Infant feeding decisions among women living with HIV (WLHIV) represent a complex intersection of public health guidance, personal values, and lived experiences. Although antiretroviral therapy has reduced vertical transmission risks, these decisions remain fraught with challenges. This qualitative evidence synthesis reviewed 41 studies published up to February 2025, exploring WLHIV's breastfeeding experiences through thematic analysis. Four overarching themes emerged: (a) the contradiction of stigma in breastfeeding and formula feeding, (b) breastfeeding for health benefits versus formula feeding to prevent HIV transmission, (c) breastfeeding for personal beliefs and emotional bonding, and (d) the influence of national infant feeding policies and health care systems. Findings reveal that feeding choices are deeply personal and shaped by sociocultural, structural, and emotional contexts. The review highlights the importance of women-centered care that respects women's autonomy, whereas urging health care providers to deliver consistent, empathetic, and comprehensive support to empower WLHIV in making informed decisions.