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 operations research related to prevention of vertical transmission of HIV from mother to child at birth and during breastfeeding was virtually flat from 2011 to 2012 at US$43.8 million. The public sector accounted for most of this funding, with the US, through the NIH and USAID, contributing 79 percent. Other public-sector agencies—ANRS, Canada’s CHVI, India’s DBT, the Swedish Research Council (SRC) and the EC, contributed 19 percent of total funding for prevention of vertical transmission R&D, while philanthropic funding accounted for 2 percent.
In 2012, this area of HIV prevention R&D shifted its focus to Option B+, a new approach recommended by the WHO in which all HIV-infected pregnant and breastfeeding women are eligible for lifelong antiretroviral therapy (ART) regardless of CD4 count. In April 2012, after having publicized the Option B+ approach, the WHO released a technical update explaining its advantages and challenges, including the need to evaluate the experiences of those countries that adopted it. As a result, evaluations and studies of implementation of Option B+ are now underway.
Additional research endeavors are exploring the ways ARVs function in prevention of vertical transmission, both at birth and through breastfeeding; ARV resistance in HIV-positive women taking regimens designed to prevent vertical transmission; and retention and recruitment of women and infants in prevention of vertical transmission.