childinfo.org: HIV/AIDS

Last update:
April 2008

Reduce the proportion of infants infected with HIV by 20 per cent by 2005 and by 50 per cent by 2010*

Prevent Mother-to-Child Transmission of HIV

WHO, UNICEF and UNAIDS, Towards Universal Access: Scaling up priority HIV/AIDS interventions in the health sector, Geneva, 2007.

The Challenge

In 2007, an estimated 1.5 million [1.2–1.8 million] pregnant women in low- and middle-income countries were living with HIV. Each year, many children are newly infected with HIV, mainly through mother-to-child transmission. An overwhelming majority—more than 90 per cent—of HIV infections in infants and children are passed on by mothers during pregnancy, labour, delivery or breastfeeding.

Approximately 50 per cent of infants infected with HIV from their mothers die before their second birthday. The transmission of HIV infection from mother to child can be sharply reduced if antiretrovirals are administered to a woman during pregnancy and delivery and to her infant shortly following its birth.

Part of the UNGASS target of reducing the proportion of infants infected with HIV by 20 per cent by 2005 and by 50 per cent by 2010 is ensuring that 80 per cent of pregnant women accessing antenatal care receive information, counselling and other HIV prevention services. Pregnant women with HIV need voluntary and confidential counselling and testing, access to antiretroviral therapy, safe delivery practices, and guidance in selecting a suitable infant-feeding option in order to prevent mother-to-child transmission (PMTCT) of HIV.

Progress

World Fit for Children Indicator*

Percentage of HIV-infected pregnant women who received antiretrovirals to reduce the risk of mother-to-child transmission of HIV

The majority of countries are making substantial progress towards preventing mother-to-child transmission of HIV. Low- and middle-income country reports show that the proportion of HIV-positive pregnant women receiving antiretrovirals to reduce the risk of transmission increased from 10 per cent in 2004 to 23 per cent in 2006. Progress is especially noticeable in sub-Saharan Africa, and more particularly in Eastern and Southern Africa—the home to most newly infected children. In this region, the proportion of HIV-positive pregnant women receiving antiretrovirals for PMTCT increased from 11 per cent in 2004 to 31 per cent in 2006.

Percentage of HIV-infected pregnant women who received antiretrovirals for PMTCT in low- and middle-income countries, 2004–2006

Note: Declines in coverage values in some regions may be due to an increase in the number of countries reporting data and the consequent increase in the denominator (estimates of HIV-infected pregnant women). The bar ( I ) indicates the range around the estimates that define the boundaries within which the actual numbers lie, based on the best available information.

Source: UNAIDS, UNICEF and WHO, ‘Towards Universal Access: Scaling up HIV Treatment, Care and Prevention interventions in the health sector’ (forthcoming); and UNAIDS/WHO unpublished estimates, 2007.

By the end of 2006, 21 low- and middle-income countries were on track to meet the 80 per cent coverage target by 2010, from 11 countries in 2005. Assuming an average increase of 8 per cent per year since UNGASS 2001, countries are defined as ‘on track’ if at least 48 per cent of all HIV-positive pregnant women received antiretrovirals for PMTCT in 2006.

Eight sub-Saharan African countries reached at least 48 per cent coverage on ARVs for PMTCT in 2006 and are on track to meet the UNGASS target of 80 per cent coverage by 2010

Note: The bar ( I ) indicates the range around the estimates that define the boundaries within which the actual numbers lie, based on the best available information.

Source: UNAIDS, UNICEF and WHO, ‘Towards Universal Access: Scaling up HIV Treatment, Care and Prevention interventions in the health sector’ (forthcoming); and UNAIDS/WHO unpublished estimates, 2007.

The progress observed in PMTCT implementation to date owes a great deal of support to a growing number of stakeholders, including the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the United States President’s Emergency Plan for AIDS Relief (PEPFAR), and to the increasing political commitment of national governments and the private sector. Rwanda’s rapid acceleration, for example, was spurred by the establishment of the annual ‘National Paediatric Conference on Treatment, Care and Support to Children Infected and Affected by HIV and AIDS’, for purposes of tracking progress and sharing scientific developments. Despite the marked increase in access to PMTCT services during the past year, the world is far short of the 80 per cent coverage target. Poor geographical service reach, aggravated by weak health systems, and the fear, stigma and denial that discourage women from being tested for HIV are significant barriers to wider uptake of PMTCT services.

Notes

*Follows the United Nations General Assembly Special Session (UNGASS) on HIV and AIDS goals.

References

Expanded Inter-Agency Task Team (IATT) on Prevention of HIV Infection in Pregnant Women, Mothers and their Children, A Report Card on Prevention of Mother-to-Child Transmission of HIV and Paediatric HIV Care and Treatment in Low- and Middle-Income Countries: Scaling up Progress from 2004–2005, 2007.

UNAIDS and WHO, Aids Epidemic Update, Geneva, 2007.

UNICEF, Progress for Children: A World Fit for Children Statistical Review, No. 6, New York, 2007.

UNICEF, UNAIDS and WHO, Children and AIDS: Second Stocktaking Report, New York, 2008.

UNICEF, UNAIDS and WHO, Children and AIDS: A Stocktaking Report, New York, 2006.

WHO, UNICEF and UNAIDS, Towards Universal Access: Scaling up HIV Treatment, Care and Prevention Interventions in the Health Sector (forthcoming).

WHO, UNICEF and UNAIDS, Towards Universal Access: Scaling up priority HIV/AIDS interventions in the health sector, Geneva, 2007.