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Prevention of mother-to-child HIV transmission within the continuum of maternal, newborn, and child health services

Chi, Benjamin H.; Bolton-Moore, Carolyn; Holmes, Charles B.

doi: 10.1097/COH.0b013e3283637f7a
PREVENTION OF MOTHER TO CHILD TRANSMISSION: Edited by Lynne M. Mofenson

Purpose of review: To reach virtual elimination of pediatric HIV, programs for the prevention of mother-to-child HIV transmission (PMTCT) must expand coverage and achieve long-term retention of mothers and infants. Although PMTCT have been traditionally aligned with maternal, newborn, and child health (MNCH) services, novel approaches are needed to address the increasing demands of evolving global PMTCT policies.

Recent findings: PMTCT-MNCH integration has improved the uptake and timely initiation of antiretroviral therapy (ART) among treatment-eligible pregnant women in public health settings. Postpartum engagement of HIV-infected mothers and HIV-exposed infants has been insufficient, although alignment of visits to the childhood immunization schedule and establishment of integrated mother-infant clinics may increase retention. Evidence also suggests that the integration of maternal HIV testing into childhood immunization clinics can significantly increase the identification of at-risk HIV-exposed infants previously missed by traditional PMTCT models.

Summary: Targeted service integration models can improve PMTCT uptake. However, as global PMTCT policy shifts to universal provision of maternal ART during pregnancy (i.e., Option B/B+), these findings must be reexamined in the context of increased service demand and systems burden. Intensive evaluation is needed to ensure quality clinical care is maintained both for PMTCT and for underpinning MNCH services.

aCentre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia

bSchools of Medicine and Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

Correspondence to Dr Benjamin H. Chi, Plot 1275 Lubutu Road, P.O. Box 34681, Lusaka, Zambia. Tel: +260 211 293 772; fax: +260 211 293 766; e-mail: bchi@cidrz.org

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