Vertical transmission or mother-to-child transmission, is the main source of the HIV infection in children. This paper published in Cadernos de Saúde Pública (Reports in Public Health) estimates the risk of vertical transmission and assesses the associated factors and missed opportunities for prevention in a cohort of HIV positive pregnant women treated in Goiânia, Goiás, Brazil, between 1995 and 2001 with follow-up of their children until 2005. The study uses three information sources to estimate the vertical transmission rates, factors associated with vertical transmission and use of antiretroviral therapy.

The authors found that the overall risk of vertical HIV transmission was 28 per cent. The vertical transmission rate was 40 per cent in the group without prophylaxis and 1 per cent in the group with adequate prophylaxis, i.e., prophylaxis resulted in a 98 per cent reduction in transmission risk. The study showed an important reduction in the risk of vertical transmission in pregnant women who received adequate therapy.

These results demonstrate the importance of early diagnosis as the first strategy, which makes possible the determination of adequate conducts for the protection of children exposed to HIV. It emphasises the importance of routine HIV screening during pregnancy. This study also points out the necessity for training health professionals throughout the state and implementing strategies directed to the more vulnerable groups, who are poorly educated adolescents with unfavourable socioeconomic conditions.

[adapted from author]