[HIV transmission from mother to child--can the epidemic be stopped?]

Abstract

Background: HIV (human immunodeficiency virus) may be transmitted from mother to child during pregnancy, delivery and breast-feeding. Transmission can be prevented, and efficient methods have caused vertical transmission to become rare in Europe and the USA. The article discusses the global HIV epidemic among children and challenges in reducing transmission from HIV-positive mothers.

Material and methods: The article is based on literature retrieved through a non-systematic search in Medline and experience from working as a paediatrician in Botswana.

Results: HIV transmission from mother to child can be reduced from about 30 % to 4 % with relatively simple measures. In many high-endemic areas in Sub-Saharan Africa, little is done to prevent HIV transmission to neonates. Major challenges exist in identifying pregnant women with HIV, especially in areas which lack pregnancy surveillance programmes.

Interpretation: To prevent neonatal transmission, safe feeding practices should be encouraged and retroviral drugs should be available. The increasing focus and investments in HIV prevention are possible explanations for the decline of the epidemic.