Progress in reducing mother-to-child transmission of HIV has been dramatic since the introduction in 2011 of the ‘Global Plan towards the Elimination of New HIV Infections among Children, and Keeping their Mothers Alive’ – largely because of increased access to PMTCT-related services and increased number of pregnant women living with HIV being initiated on lifelong antiretroviral medicines. But it has not been fast enough to reach the 2020 targets set by UNAIDS and partners as part of the Super-Fast-Track Framework to end AIDS. Acceleration of treatment for all pregnant and breastfeeding women living with HIV is still needed to achieve elimination of new infections among children and halve HIV-related deaths among pregnant women and new mothers.
More pregnant women than ever before receive treatment to stop HIV transmission to their children
Fast facts:
- As a result of higher testing coverage in high HIV burden countries, an increasing number of pregnant women in low- and middle-income countries are being tested for HIV during pregnancy.
- In 2017, 80 per cent of pregnant women living with HIV globally were receiving effective antiretroviral medicines for prevention of mother-to-child transmission (PMTCT), up from 51 per cent in 2010. Almost 100 per cent of pregnant women receiving ARVs were receiving lifelong antiretroviral therapy (ART).
- In 2017, an estimated 1.4 million pregnant women were living with HIV globally.
- Approximately 91 per cent of these women live in sub-Saharan Africa.
Among UNICEF regions, Eastern and Southern Africa has the highest coverage (93 per cent) of effective antiretroviral medicines among pregnant women who are HIV-positive, followed by Latin America and the Caribbean (73 per cent). All other regions have coverage of under 60 per cent: East Asia and the Pacific (57 per cent), South Asia (54 per cent), West and Central Africa (47 per cent), and Middle East and North Africa (41 per cent). PMTCT coverage data for Eastern Europe and Central Asia, North America and Western Europe are not available.
Regional variations exist in access to antiretroviral treatment for pregnant and breastfeeding women
Fast fact:
- Access to antiretroviral treatment for pregnant women ranges from 93 per cent in Eastern and Southern Africa to 41 per cent in Middle East and North Africa.
Expanding HIV testing and counselling among pregnant women is critical for identifying those in need of follow-up care and increasing coverage of subsequent interventions that can prevent mother-to-child transmission, as well as provide care and treatment to the mother.
As per current guidance from the World Health Organization (WHO), transmission of the virus from mother to child can be significantly reduced if lifelong antiretroviral treatment is administered according to the WHO guidelines. About 90 per cent of HIV infections in infants and children are passed on from their mothers during pregnancy, delivery or breastfeeding.
Without any intervention, between 15 per cent and 45 per cent of babies born to HIV-positive mothers are likely to become infected. And half of all infants infected with HIV are likely to die before their second birthday if they do not receive treatment.
Reducing HIV transmission from mother to child requires a range of interventions, beginning with voluntary and confidential counselling and testing for the virus. This should be followed by lifelong antiretroviral treatment for pregnant women with HIV and the administration of antiretroviral drugs to their newborns as a preventive measure, as well as safe delivery practices and retention of the mother and infant into long-term care and treatment.
The critical strategies through which elimination of new infections among children and keeping mothers alive can be achieved include: knowledge of HIV status, initiation and retention on antiretroviral treatment with attainment of viral suppression.
WHO guidelines recommend that all infants born to HIV-positive mothers should receive antiretroviral drugs preventively. Data show that the use of services related to the prevention of mother-to-child transmission of HIV is expanding. Poor service delivery in the post-partum period with significant low rates of maternal retention, populations living in hard-to-reach areas, aggravated by weak health systems, and the fear, stigma and denial that continue to discourage women from being tested for HIV are significant barriers to wider uptake of services.
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