Abstract:
Vertical transmission of HIV
can occur during pregnancy,
delivery, or through breast
feeding. The main driver of
vertical transmission is a high
maternal viral load. Between 2002 and
2016, low and middle income countries
(LMICs) in sub-Saharan Africa with high
HIV prevalence improved their policies
to prevent vertical transmission of HIV.
In 2002, national policies recommended
single dose nevirapine at the onset of
labour, with limited or no breast feeding.
By 2016, all Global Plan priority countries
in sub-Saharan Africa (where 90% of the
world’s HIV positive pregnant women live)
had adopted Option B+ with promotion of
breast feeding. Option B+ was a dramatic
policy change recommending lifelong
triple antiretroviral therapy (ART) for all
pregnant and lactating women living with
HIV. The aim is to protect the child from
HIV infection, ensure the mother’s future
health, and prevent horizontal transmission
of HIV.
