Protocol 10. Prevention of HIV transmission from HIV infected mothers to their infants

Increasing numbers of women living with HIV are becoming pregnant, and their infants will be at high risk for acquiring HIV infection in utero, during labour or through breastfeeding. In the absence of interventions, the risk of mother-to-child transmission (MTCT) of HIV is 15–30% in non-breastfeeding populations; breastfeeding increases the risk to 20–45%.

Effective interventions for the prevention of MTCT (PMTCT) of HIV infection do now exist. Where these interventions are freely available and utilized, MTCT rates of 1% or 2% have been achieved. The challenge is to achieve similar rates throughout the WHO European Region, particularly in countries where the HIV epidemic is fuelled by injecting drug use and health systems are adversely affected by economies in transition. Several factors – high-level coverage of antenatal care (ANC), the availability of an extensive health care infrastructure, high literacy levels, a relatively low number of infections and the existence of effective interventions to reduce MTCT – offer an opportunity to eliminate infant HIV infection in the Region and thus provide a model for the rest of the world.