Family Planning and the Prevention of Mother-to-Child Transmission of HIV

Mother-to-child transmission is the main way children become infected with human immunodeficiency virus (HIV) worldwide. To date, the primary approach to the prevention of mother-to-child transmission (PMTCT) has been to identify HIV-infected pregnant women by voluntary counseling and testing (VCT) for HIV and then provide antiretroviral (ARV) drug prophylaxis to them during delivery and then to their newborn infants. Many HIV-positive births could be prevented, however, by simply preventing unintended pregnancies among infected women. Furthermore, increasing contraceptive use to prevent such pregnancies appears to be at least as cost-effective as providing nevirapine to HIV-infected mother.  This review summarizes the literature on integrating family planning services with other services to prevent HIV-positive births.