Abstract
Most children infected with human immunodeficiency virus type 1 (HIV-1) acquire infection by mother-to-child transmission. Progress in understanding HIV-1 transmission, its diagnosis, and its treatment has led to strategies that are remarkably effective in the prevention of perinatal HIV-1 transmission in the United States and other countries with adequate resources. There have been reports of rates of perinatal transmission of between 1 and 4% (1–3). Prophylaxis trials in countries with limited resources using short courses of antiretroviral drugs to interrupt perinatal transmission have provided promising results (4–8). Despite these results, there continue to be large numbers of infants born every year in these countries who are HIV-1 infected. The World Health Organization estimated that, worldwide, as many as 640,000 HIV-1-infected infants were born in 2004 (9). Significant obstacles, many of which are economic, have prevented the implementation of strategies that could be effective in decreasing perinatal transmission in these countries.