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The burden of the HIV/AIDS pandemic, including mother-to-child transmission of HIV, disproportionately affects low- and middle-income countries, in particular the countries of Southern Africa. [2] The World Health Organization (WHO) estimates that 1.3 million women and girls living with HIV become pregnant each year. [3]
Programs to prevent the vertical transmission of HIV (from mothers to children) can reduce rates of transmission by 92–99%. [ 84 ] [ 142 ] This primarily involves the use of a combination of antiviral medications during pregnancy and after birth in the infant, and potentially includes bottle feeding rather than breastfeeding .
Human immunodeficiency virus (HIV) infection can occur during delivery of the neonate, in utero through mother-to-child transmission or postnatally by way of breastfeeding. Most transmission occurs during delivery. Transmission depends on multiple risk factors, usually centered around the viral load of HIV in the mother.
Programs to prevent the transmission of HIV from mothers to children can reduce rates of transmission by 92–99%. [47] [57] This primarily involves the use of a combination of antivirals during pregnancy and after birth in the infant but also potentially include bottle feeding rather than breastfeeding.
During 1994 to 1999, AZT was the primary form of prevention of mother-to-child HIV transmission. AZT prophylaxis prevented more than 1000 parental and infant deaths from AIDS in the United States. [ 22 ]
Although prevention of mother to child transmission (PMTCT) programs have been implemented across different regions, their success in resource-constrained settings is still widely debated upon. [9] In 2008, the majority of sub-Saharan Africa as a whole had an estimate of 430,000 HIV infections among children under the age of 15. [9]
Treatment as prevention has been used as a form of controlling the spread of HIV since the mid-1990s, initially in the context of preventing the transmission of the virus from mothers to their children. Research in 1994 revealed how the drug zidovudine can reduce vertical transmission. [14]
Furthermore, the PARTNER study, [43] which ran from 2010 to 2014, enrolled 1166 serodiscordant couples (where one partner is HIV positive and the other is negative) in a study that found that the estimated rate of transmission through any condomless sex with the HIV-positive partner taking ART with an HIV load less than 200 copies/ml was zero.
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