Mother-to-Child Transmission of HIV: Insights and Recommendations

Mother-to-child transmission is the primary route of HIV infection in children under 15 years of age. Since the beginning of the HIV epidemic, an estimated 5.1 million children worldwide have been infected with HIV (UNAIDS 2000). Clinical trials in several countries have shown that mother-to-child transmission of HIV can be greatly reduced through administering a short, affordable course of antiretroviral therapy to pregnant women. These trials culminated in a recommendation by UNAIDS and its partners in the Interagency Task Team for the Prevention of Mother-to-Child Transmission that prevention of perinatal transmission should be a part of the standard package of care for HIV-positive women and their children (UNAIDS 2000). Moreover, it is quickly becoming clear that prevention programs can enhance communities ’ understanding of and response to HIV. As a result, governments in Africa, Asia, and Latin America in collaboration with international and nongovernmental organizations have moved rapidly to improve antenatal care and incorporate interventions to prevent transmission of HIV from mother to child into clinical and community-based care. The acceptability, operational concerns, costs, and impact of this package of services o