Antiretroviral Drug Regimens to Prevent Mother-To-Child Transmission of HIV: A Review of Scientific, Program, and Policy Advances for Sub-Saharan Africa
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Considerable advances have been made in the effort to prevent mother-to-child HIV transmission (PMTCT) in sub-Saharan Africa. Clinical trials have demonstrated the efficacy of antiretroviral regimens to interrupt HIV transmission through the antenatal, intrapartum, and postnatal periods. Scientific discoveries have been rapidly translated into health policy, bolstered by substantial investment in health infrastructure capable of delivering increasingly complex services. A new scientific agenda is also emerging, one that is focused on the challenges of effective and sustainable program implementation. Finally, global campaigns to “virtually eliminate” pediatric HIV and dramatically reduce HIV-related maternal mortality have mobilized new resources and renewed political will. Each of these developments marks a major step in regional PMTCT efforts; their convergence signals a time of rapid progress in the field, characterized by an increased interdependency between clinical research, program implementation, and policy. In this review, we take stock of recent advances across each of these areas, highlighting the challenges—and opportunities—of improving health services for HIV-infected mothers and their children across the region.
KeywordsPrevention of mother-to-child HIV transmission PMTCT HIV Antiretroviral prophylaxis Sub-Saharan Africa Global epidemic
The authors would like to thank Dr. Charles Holmes for his review of the manuscript and Dr. Andreas Jahn for his insight about the Malawi national program for the prevention of mother-to-child transmission of HIV.
Conflict of Interest
Benjamin H. Chi declares no conflict of interest.
Jeffrey S. A. Stringer declares no conflict of interest.
Dhayendre Moodley declares no conflict of interest.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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