Current standards for HIV vertical transmission prevention

Area of Science:

• * Public Health
• * Infectious Diseases
• * Pediatric Medicine

Background:

• * Vertical transmission of Human Immunodeficiency Virus (HIV) poses a significant risk to newborns and infants, ranging from 15% to 45% without intervention.
• * High maternal viral load is the primary risk factor for HIV transmission from mother to child.
• * Prevention guidelines vary significantly between high-income and low- to middle-income countries, impacting interventions like caesarean sections, infant antiretroviral care, and feeding practices.

Purpose of the Study:

• * To provide a comprehensive review of strategies for the elimination of pediatric HIV.
• * To discuss current standards of care and prevention methods for vertical HIV transmission.
• * To highlight differences in approaches between well-resourced and lower-resourced settings.

Main Methods:

• * Literature review focusing on HIV prevention in pregnancy, labor, delivery, and breastfeeding.
• * Analysis of current standards of care for preventing vertical HIV transmission.
• * Comparison of prevention strategies in high-income versus low- and middle-income countries.

Main Results:

• * Key differences in prevention strategies include caesarean section rates, infant antiretroviral prophylaxis, and infant feeding recommendations.
• * Emerging strategies show potential for further reduction in vertical HIV transmission.
• * Persistent challenges in sub-Saharan Africa include health system gaps, loss to care, and reduced donor funding impacting progress.

Conclusions:

• * Comprehensive approaches are necessary for the elimination of pediatric HIV.
• * Tailored strategies considering resource availability are essential for effective prevention of vertical transmission.
• * Sustained funding and addressing health system weaknesses are critical to maintain and advance progress in preventing mother-to-child HIV transmission.