Elimination of paediatric HIV in KwaZulu-Natal, South Africa: large-scale assessment of interventions for the prevention of mother-to-child transmission

In 2008, HIV prevalence among women attending government-run antenatal clinics in the South African province of KwaZulu-Natal was 38.7%. In April of 2008, the Department of Health provided antenatal zidovudine from 28 weeks’ gestation to HIV-infected pregnant women, in addition to the single-dose nevirapine it was already providing to such women and their babies at delivery. The Department of Health also commissioned an impact assessment to determine to what extent the programme’s goal, to reduce HIV infection in infants, was being achieved. This article reports the findings of a study, designed to determine the rates of mother-to-child transmission of HIV in KwaZulu-Natal, in which all infants attending immunization clinics for their first immunizations served as a population proxy. It found that in the province with the highest HIV prevalences, low rates of mother-to-child transmission at population level were achieved within a short period.