title: Beyond prevention of mother-to-child transmission: keeping HIV-exposed and HIV-positive children healthy and alive.
abstract: In 2011, Joint United Nations Programme on HIV/AIDS announced a plan to eliminate new HIV infections among children by 2015. This increased focus on the elimination of maternal to child transmission (MTCT) is most welcome but is insufficient, as access to prevention of MTCT (PMTCT) programming is neither uniform nor universal. A new and more expansive agenda must be articulated to ensure that those infants and children who will never feel the impact of the current elimination agenda are reached and linked to appropriate care and treatment. This agenda must addresses challenges around both reducing vertical transmission through PMTCT and ensuring access to appropriate HIV testing, care, and treatment for all affected children who were never able to access PMTCT programming. Option B+, or universal test and treat for HIV-infected pregnant women is an excellent start, but it may be time to rethink our current approaches to delivering PMTCT services. New strategies will reduce vertical transmission to less than 1% for those mother-infant pairs who can access them allowing for the contemplation of not just PMTCT, but actual elimination of MTCT. But expanded thinking is needed to ensure elimination of pediatric HIV.
authors.affiliation: aManagement Sciences for Health, Washington, DC bBaylor College of Medicine, Texas Childrens Hospital, Houston, Texas cManagement Sciences for Health, Cambridge, Massachusetts dOffice of HIV/AIDS, USAID, Washington, DC eClinton Health Access Initiative, New York City, New York, USA fManagement Sciences for Health, Lilongwe, Malawi gICAP - Columbia University, Mailman School of Public Health, New York, New York, USA.
authors.forename: Scott E
authors.initials: SE
authors.lastname: Kellerman
authors.forename: Saeed
authors.initials: S
authors.lastname: Ahmed
authors.forename: Theresa
authors.initials: T
authors.lastname: Feeley-Summerl
authors.forename: Jonathan
authors.initials: J
authors.lastname: Jay
authors.forename: Maria
authors.initials: M
authors.lastname: Kim
authors.forename: B Ryan
authors.initials: BR
authors.lastname: Phelps
authors.forename: Nandita
authors.initials: N
authors.lastname: Sugandhi
authors.forename: Erik
authors.initials: E
authors.lastname: Schouten
authors.forename: Mike
authors.initials: M
authors.lastname: Tolle
authors.forename: Fatima
authors.initials: F
authors.lastname: Tsiouris
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D014943:Global Health; D015658:HIV Infections / Q000175:diagnosis / Q000517:prevention & control* / Q000635:transmission*; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000266:history / Q000517:prevention & control*; D059012:Lost to Follow-Up; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000517:prevention & control*; D011314:Preventive Health Services / Q000266:history*; D016730:Program Development; D011785:Quality Assurance, Health Care / Q000379:methods / Q000592:standards* / Q000639:trends; D014480:United Nations; D014944:World Health Organization
chemical_list: D019380:Anti-HIV Agents