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Putting the Health of Young Mothers First: Key to Stopping AIDS

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A young woman in sub-Saharan Africa is as much as four times more likely to be infected with HIV than a young man her age. While anti-retroviral drugs have saved countless lives, HIV is still the leading cause of death for women in their reproductive years.

Young women are the most vulnerable to HIV. If we are to stop the epidemic, we must give them the means to protect their health.

Today UNICEF released the 6th Stocktaking Report on Children and AIDS. The Report is showcasing the breakthroughs in the 30 year epidemic, which now make it possible to nearly eliminate the risk of women living with HIV passing the virus to their babies.

In the United States, mother-to-child transmission of HIV has all but disappeared. Most American women seek medical care during pregnancy. The U.S. Centers for Disease Control and Prevention (CDC) has recommended HIV testing of all pregnant women as part of the basic package of prenatal services for nearly two decades. Women found to be HIV positive are offered medicines to protect their own health and that of their babies.

Although the global number of HIV-infected babies born each year has dropped by more than half since 2005, 260,000 babies became newly infected with HIV -- more than one every two minutes -- this past year alone.

In order to stop the disease in its tracks, HIV-positive pregnant women need care immediately after diagnosis. Healthy mothers raise healthier children, and given that a person on HIV treatment is also 95 percent less likely to pass the virus to a sexual partner, more people on treatment means less HIV in the whole community.

Unfortunately, in the past, the focus of global mother-to-child HIV prevention efforts was on saving babies -- but not necessarily mothers. In limited-resource settings, policy makers had to consider who required the medicines most urgently and therefore provided comprehensive treatment only to people whose HIV had progressed.

What this policy meant in practice was that an HIV-positive pregnant woman who had a high CD4 count -- the measure used to assess the strength of the immune system -- was given medicine to save her baby only.

Thankfully, changes to this policy are underway in many countries. In Malawi, for example, the government removed all restrictions on access to comprehensive treatment in 2011. They knew that this approach would make it easier to keep HIV-positive mothers healthy and ensure that no babies were born with HIV.

As a result, the number of pregnant women on HIV treatment has increased dramatically -- from 1,250 new patients in the quarter before the new policy started to 10,650 new patients in the same quarter one year later. In addition, the number of new HIV-infections in babies has been cut in half.

In July 2013, the World Health Organization changed its HIV treatment guidelines to recommend universal HIV testing and treatment for all pregnant women found to be HIV- positive. So far, among the 22 countries that are home to approximately 90 percent of babies that contract HIV through their mothers, 13 have adopted this policy and another six have adopted a less comprehensive but still improved policy.

A partnership led by UNICEF and WHO with 32 other organizations is coordinating technical assistance, developing guidance and tools, and monitoring progress in countries.

Putting the health of mothers first is a moral imperative. Doing so will protect their lives and make HIV programs more effective. It is critical to achieving an AIDS-free generation.

The Children and AIDS: Sixth Stocktaking Report can be found at www.childrenandaids.org