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More Than Baby Steps Needed to End Vertical Transmission of HIV
Progress Made, But More Needed to Reach Zero
Universal third-trimester retesting and partner testing may better identify incident HIV among pregnant women and improve uptake of interventions to prevent vertical transmission.
The document is an important tool to support efforts to reduce and eventually end vertical transmission of HIV. Mother-to-child transmission or vertical transmission is a significant contributor to the HIV epidemic, accounting for approximately 15% of all new HIV infections globally. Vertical transmission prevention programmes have averted 34 million new HIV infections in children since 2000. However, progress has slowed in recent years, and an estimated 150,000 children were newly infected with HIV in 2021.
Since the global shift to and accelerated rollout of highly effective simplified interventions based on a public health approach, an additional 14 countries have achieved elimination of vertical transmission of HIV and congenital syphilis as a public health problem. This brings the total number of countries that have achieved elimination to 32.
From May to November 2019 we identified numerous promising evidencebased strategies that, if scaled up, could contribute to ending vertical transmission of HIV and congenital syphilis by 2030. These strategies include:
- Strengthening the health system to deliver high-quality antenatal care, labour and delivery, and postnatal care, including HIV testing and counselling, and access to HIV treatment, infant feeding counselling, and prophylaxis for infants.
- Increasing the uptake of antenatal care and delivery in health facilities, and improving the quality of services provided in these settings.
- Providing HIV testing and counselling to all pregnant women and their partners.
- Offering and providing access to a range of effective interventions to prevent vertical transmission of HIV, including antiretroviral therapy (ART) for pregnant and breastfeeding women, and prophylaxis for infants.
- Supporting women to make informed choices about infant feeding, including providing counselling and support on breastfeeding and safe alternatives.
- Monitoring and evaluating vertical transmission prevention programmes, including surveillance for HIV in pregnant women and children, and tracking progress towards elimination.
- Advocating for the allocation of resources to scale up vertical transmission prevention programmes.
By implementing these strategies, we can accelerate progress towards ending vertical transmission of HIV and congenital syphilis, and ensure that all children are born HIV-free.