Résumé
The 2009 WHO recommendations for the prevention of HIV transmission through breastfeeding advise the use of pharmaceutical prophylaxis with a single infant feeding mode selected at the regional or national level, i.e., exclusive breastfeeding for West African countries. HIV-positive women should be “educated” to increase the efficacy of this new strategy. These recommendations engendered unexpected resistance in Senegal from HIV-positive women who protested publicly. This collective protest was quite new in a setting where PLHIV-organization members are considered social counselors rather than activists, and women are seen as natural caregivers and good patients rather than community health experts. Based on a study held with an association of HIV-positive women and within the public health system, this chapter presents analysis of international policies regarding HIV transmission through breastfeeding and women’s roles in prevention before 2009, the local determinants for adoption of the new strategy, and women’s perceptions of HIV risk and protest. Contrary to international policies and stakeholders who statge that the implementation of a pharmaceutical strategy for prevention is a step towards eradication of mother-to-child HIV transmission, women think that the efficacy of this strategy is not sufficient to protect their infants. They call for their participation in making decisions on public health strategies that concern them as mothers and as associative caregivers and counselors. Their protest is also a quest to be acknowledged for their autonomy and expertise.