Abstract:
South Africa has made great strides in reducing the vertical transmission of human
immunodeficiency virus (HIV) in the first two months of life from 23% (2003) to 0.7% (2019),
despite a persistently high antenatal HIV prevalence of around 30%. Improving access to
antiretroviral therapy during antenatal care has significantly contributed to this success, but has
led to an increase in the relative proportion of vertical transmissions due to breastfeeding in the
first six months post-delivery. Yet, due to the short- and long-term benefits of breastfeeding and
risks associated with not breastfeeding, mothers need to be supported to breastfeed their infants
for the longest duration possible, while maintaining virological suppression to reduce the vertical
transmission risk.
