Preventing Mother-to-Child Transmission: Critical to Ending the HIV Epidemic

Integrating Family Planning and HIV Services

Elena Ghanotakis

EMG Consulting and Multi-Media Inc. | Independent Consultant
Antenatal care exam (GHeL PMTCT course)

Antenatal care exam. Photo: UNICEF.

As the world focuses on ending the AIDS epidemic in children, adolescents, and young women by 2020 as part of the Start Free, Stay Free, AIDS Free Super-Fast-Track framework, programs for prevention of mother-to-child transmission of HIV (PMTCT) are critical to these efforts. Ninety percent of HIV infections in children under the age of 15 are estimated to occur through mother-to-child transmission (MTCT). Without antiretroviral therapy (ART), the risk of HIV transmission from a mother living with HIV to her infant varies between 15% and 45%. However, new HIV infections in children from MTCT can be dramatically reduced (to below 5%) by giving mothers ART during pregnancy, labor, delivery, and breastfeeding, and continuing ART for life. Today, ART is the cornerstone of PMTCT programs.

In the past decade, interventions to prevent HIV transmission from mothers living with HIV to their infants have evolved substantially. The increasing scale-up and quality of PMTCT programs globally are among the greatest successes of the Global AIDS Response to date. At the end of 2016, 76% of pregnant women living with HIV globally received antiretroviral drugs (ARVs) for PMTCT (up from 47% in 2010). In 2016, PMTCT programs were attributed to averting an estimated 270,000 new HIV infections in children (up from 200,000 in 2010). It is important for the focus on increasing scale-up and quality of PMTCT programs to continue to maintain the momentum achieved, prevent new HIV infections in children through MTCT, and end the HIV epidemic.

The newly updated Global Health eLearning Center course, Mother-to-Child Transmission of HIV, provides an overview of the global HIV epidemic, including MTCT and PMTCT. It takes an in-depth look at each of the four elements of a comprehensive approach to preventing MTCT during the antenatal, intrapartum, and postpartum periods:

  1. Primary HIV prevention among women of reproductive age
  2. Prevention of unintended pregnancies among women living with HIV
  3. Prevention of HIV transmission from women living with HIV to their infants
  4. Provision of appropriate treatment, care, and support to women and children living with HIV and their families

Finally, the course examines key programming considerations, such as monitoring and evaluation, early and decentralized HIV testing and diagnosis, maternal retention and loss-to-follow-up, integration, linkages, the role of male involvement, and community-led solutions.