Elimination of mother-to-child transmission of HIV infection: The drug resource enhancement against AIDS and malnutrition model

Giuseppe Liotta, Maria Cristina Marazzi, Khethimipilo E. Mothibi, Ines Zimba, Evelyne E. Amangoua, Esther K. Bonje, Bernard N B Bossiky, Precious A. Robinson, Paola Scarcella, Kebby Musokotwane, Leonardo Palombi, Paola Germano, Pasquale Narciso, Andrea De Luca, Elard Alumando, Sangare H. Mamary, Nurja A. Magid, Giovanni Guidotti, Sandro Mancinelli, Stefano OrlandoMarco Peroni, Ersilia Buonomo, Karin Nielsen-Saines

Research output: Contribution to journalArticlepeer-review


The Drug Resource Enhancement against AIDS and Malnutrition Program (DREAM) gathered professionals in the field of Elimination of HIV-Mother-To-Child Transmission (EMTCT) in Maputo in 2013 to discuss obstacles and solutions for the elimination of HIV vertical transmission in sub-Saharan Africa. During this workshop, the benefits of administrating combined antiretroviral therapy (cART) to HIV positive women from pregnancy throughout breastfeeding were reviewed. cART is capable of reducing vertical transmission to less than 5% at 24 months of age, as well as maternal mortality and infant mortality in both HIV infected and exposed populations to levels similar to those of uninfected individuals. The challenge for programs targeting eMTCT in developing countries is retention in care and treatment adherence. Both are intrinsically related to the model of care. The drop-out from eMTCT programs before cART initiation ranges from 33%–88% while retention rates at 18–24 months are less than 50%. Comprehensive strategies including peer-to-peer education, social support and laboratory monitoring can reduce refusals to less than 5% and attain retention rates approaching 90%. Several components of the model of care for reduction of HIV-1 MTCT are feasible and implementable in scale-up strategies. A review of this model of care for HIV eMTCT is provided.

Original languageEnglish
Pages (from-to)13224-13239
Number of pages16
JournalInternational Journal of Environmental Research and Public Health
Issue number10
Publication statusPublished - Oct 21 2015


  • DREAM program
  • Elimination of HIV MTCT

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


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