Keeping the M in MTCT: women, mothers, and HIV prevention

This paper tackles the issue of prioritizing public health interventions in reducing mother-to-child transmission (MTCT) of HIV in the context of child survival and the benefits and obligations of women who are mothers. One of the challenges of building the social context into the prevention strategies is to retain the biological specificity of HIV. It is known that AIDS is a disease associated with poverty and with inequality between the sexes. Moreover it is also an infectious disease caused by a virus. For the infant it is maternal infection that matters and it is MTCT that needs to be interrupted. MTCT is an accurate phrase and as a paradigm it has yielded the highly effective antiretroviral therapy approaches. A study showed that a single antiretroviral therapy taken for a short time can reduce MTCT by a stunning 67%. Moreover short-course zidovudine and nevirapine regimens have been shown to have long-term benefits for the breastfed infant. For many HIV-infected women a better chance to have an uninfected child is the only good news there is. In general public health interventions should focus on taking care of mothers; in turn mothers can take care of their infants.