PREVENTING MOTHER-TO-CHILD TRANSMISSION OF HIV THROUGH ARTIFICIAL FEEDING: A LEGAL-ETHICAL ANALYSIS

Abstract

The prevention of mother-to-child transmission (PMTCT) of HIV is a global public health priority. For decades, infant feeding has been a central and complex component of PMTCT strategies. While breastfeeding is the optimal source of infant nutrition, it also poses a significant risk of HIV transmission from an infected mother to her child in the absence of effective interventions. Consequently, artificial feeding with infant formula was widely promoted as a key strategy to eliminate this risk. This article provides a comprehensive legal and ethical analysis of using artificial feeding for PMTCT. Using a systematic review of international guidelines, bioethical literature, and human rights frameworks, this paper examines the evolution of recommendations and the profound dilemmas they create. The analysis highlights the inherent conflict between the biomedical goal of preventing HIV transmission and the fundamental principles of maternal autonomy, infant rights, and health equity. We explore the ethical tensions surrounding informed consent, the challenges of ensuring that artificial feeding is "Acceptable, Feasible, Affordable, Sustainable, and Safe" (AFASS), and the significant issues of stigma and discrimination faced by women who do not breastfeed. The impact of increasingly effective antiretroviral therapy (ART) in radically altering the risk-benefit calculus is also discussed. This paper argues that while artificial feeding remains a critical option in specific circumstances, a shift from a prescriptive, one-size-fits-all approach to a rights-based, woman-centered, and context-specific counseling model is essential for ethically sound and effective PMTCT programs.