Vertical Transmission Prevention

What is Vertical Transmission for HIV Prevention?

Vertical transmission of HIV (also known as mother to child transmission and abbreviated as ‘MTCT’) has been virtually eliminated in the global North. This is because treatment to prevent HIV infection in newborns has been available for over a decade. The treatment involves is providing a simple, affordable bio-medical intervention, providing ARV drugs to mother and child at birth, to a highly visible and easy to reach target population. Research into improved design of vertical transmission services at birth and during breastfeeding remain an important goal in reducing infant HIV infection.

Vertical Transmission Prevention Investment

Funding for research related to prevention of vertical transmission of HIV from mother to child at birth and during breastfeeding increased between 2013 and 2014, from approximately US$44 million to US$49 million. The public sector accounted for most of this funding, with the US, through NIH and USAID contributing more than 91 percent.

Results in 2014 confirmed that triple antiretroviral therapy among pregnant women (i.e., Option B) is effective in prevention of vertical transmission. Several studies also released important findings in 2014, including:

  • The PROMISE study, a multi-country randomized clinical trial, showed the Option B regimen superior to monotherapy during pregnancy for preventing vertical transmission. The study confirmed the 2013 WHO consolidated treatment guidelines recommending triple antiretroviral therapy for all pregnant and breastfeeding women. 
  • The Pediatric HIV/AIDS Cohort Study’s Surveillance Monitoring of Antiretroviral Therapy Toxicities Study, a prospective cohort study of HIV-exposed infants in the United States and the French Perinatal Cohort released results showing low rates of congenital anomalies among babies exposed to antiretroviral medicine at the time of conception. However, the French Perinatal Cohort reported higher rates of heart defects among infants exposed in utero.
  • In Botswana and Malawi, two additional studies showed the challenges of implementing programs to prevent vertical transmission, presenting issues with the cascade of care.  

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