Prevention of mother-to-child transmission
Situation and trends
Nearly all young children newly infected with HIV are infected through mother-to-child transmission (MTCT); about 90% of the estimated 240 000 children who newly infected with HIV in 2013 were in the WHO African Region. With provision of antiretroviral (ARV) drugs the mother-to-child transmission can decrease to less than 2% (in the absence of breast feeding) or less than 5% (depending on the duration of breastfeeding among HIV-exposed infants). Globally, there were still more than 1.4 million [1.3 million–1.6 million] pregnant women with HIV in 2013 (all of whom needed interventions for PMTCT of HIV) in low- and middle-income countries, of whom an estimated 67% [62–73%] received ARV drugs for preventing mother-to-child transmission (PMTCT) of HIV. This marks an increase in PMTCT ARV coverage from 47% [44–51%] in 2009 and 56% [52–61%] in 2011.
The number of pregnant women with HIV has remained relatively stable since, but the proportion receiving recommended ARV regimens for PMTCT of HIV has increased steadily, as has the proportion receiving more effective regimens.
Coverage of ARV drugs among pregnant women with HIV varies significantly across regions. In 2013, coverage of ARV drugs remained high in the WHO European Region*, followed by the WHO Region of the Americas (93%, range 51–>95%), and the WHO African Region (68%, range 62–74%). All the other regions have also made progress, but overall coverage in 2013 in the WHO Western Pacific Region was still relatively low at 58% [41 –77%]. Coverage was 26% [19 –31%] in the WHO South-East Asia Region as well as 26% [18% –39%] in the WHO Eastern Mediterranean Region. The total number of women receiving ARV drugs for PMTCT of HIV is strongly influenced by developments in the WHO African Region, which is home to about 87% of the pregnant women living with HIV in low- and middle-income countries.
*Coverage estimates for the WHO European Region are not available due to inconsistencies between programme coverage and estimated PMTCT need.