Successes and Challenges in the Perinatal HIV-1 Epidemic in the United States as Illustrated by the HIV-1 Serosurvey of Childbearing Women

Almost all human immunodeficiency virus type 1 (HIV-1) infections in children in the United States, as well as globally, are secondary to mother-to-child transmission (MTCT) of the virus. In the past decade, there has been impressive success in the United States and other resource-rich countries in reducing incident pediatric HIV-1 infections and a concomitant dramatic decrease in the incidence of new cases of pediatric AIDS.¹ In contrast, in resource-limited settings, initiation of testing programs to allow pregnant women to learn their HIV-1 serostatus and use of effective short-course antiretroviral interventions to prevent MTCT are just now beginning to be implemented.²