title: Should nevirapine be used to prevent mother-to-child transmission of HIV among women of unknown serostatus?
abstract: At present, HIV testing and counselling during pregnancy represent the key entry point for women to learn their serostatus and for them to access, if they are HIV-positive, specific interventions to reduce mother-to-child transmission (MTCT) of HIV. However, the provision and uptake of testing and counselling services are inadequate, and many pregnant women in countries most affected by the HIV/AIDS epidemic remain unaware of their HIV status. The offer of single-dose nevirapine prophylaxis to women whose HIV status is unknown at the time of delivery has been proposed to circumvent these problems in high-prevalence settings. The potential advantages and disadvantages of three different programme approaches are considered: targeted programmes in which antiretroviral drugs are offered only to women who are known to be HIV-positive; combined programmes in which nevirapine prophylaxis is offered to women whose serostatus remains unknown at the time of delivery despite targeted programme inputs; and universal nevirapine prophylaxis programmes in which HIV testing and counselling are not available and all pregnant women, regardless of their serostatus, are offered nevirapine prophylaxis.
authors.affiliation: Department of HIV/AIDS, World Health Organization, Geneva, Switzerland. sintt@who.int
authors.forename: Tin Tin
authors.initials: TT
authors.lastname: Sint
authors.forename: François
authors.initials: F
authors.lastname: Dabis
authors.forename: Claude
authors.initials: C
authors.lastname: Kamenga
authors.forename: Nathan
authors.initials: N
authors.lastname: Shaffer
authors.forename: Isabelle F
authors.initials: IF
authors.lastname: de Zoysa
mesh_terms: D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D006679:HIV Seropositivity; D006304:Health Status; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D019829:Nevirapine / Q000008:administration & dosage / Q000627:therapeutic use*; D011247:Pregnancy; D016730:Program Development; D018570:Risk Assessment
chemical_list: D019380:Anti-HIV Agents; D019829:Nevirapine