Mother-to-Child Transmission of HIV

In December 2000, UNAIDS and the World Health Organization (WHO) shared their most recent grim statistics on HIV with the world health community. They estimated that there are 36.1 million adults and children living with HIV infection worldwide (1). Seventy percent of these infected individuals live in sub–Saharan Africa, where more than half of the HIV-infected adults are women. The percentages of female cases of HIV are estimated to range from 53% in Botswana and Nigeria to 58% in Rwanda and Niger (2). Furthermore, high HIV seroprevalence rates have been documented among African women of childbearing age (3). Some investigators have suggested and reported evidence that HIV-infected women have lower fertility rates than their uninfected counterparts (4). However, high rates of infection, especially among adolescent African women (5), assure the continuation of the pediatric HIV epidemic in Africa until Afro-centric strategies to prevent mother-to-child transmission (MTCT) of HIV are developed and effectively implemented. Of all HIV-infected children worldwide, 87% are estimated to live in Africa (1). A TIMING OF TRANSMISSION