Vertical Transmission of HIV in Sub-Saharan Africa: Applying Theoretical Frameworks to Understand Social Barriers to PMTCT

Abstract

In sub-Saharan Africa, over 1,000 newborns are infected with HIV every day, despite available medical interventions. Pediatric HIV is a large contributor to the high rates, the largest in the world, of infant and child mortality in this region. Prevention of mother-to-child transmission of HIV (PMTCT) can dramatically reduce the risk of infection for the infant during pregnancy, childbirth, and breastfeeding. Throughout most urban areas of Africa, free medications are readily available. However, approximately 50% of HIV-positive pregnant women in sub-Saharan Africa are not accessing or adhering to the necessary medications to prevent mother-to-child transmission. In order for this region to eliminate the vertical transmission of HIV and meet the Millennium Development Goals, interventions need to move beyond the individual-level and address the structural and social barriers preventing women from utilizing PMTCT services. This paper reviews current literature on PMTCT interventions in sub-Saharan Africa from 2006–2012, specifically examining theoretical underpinnings. Overwhelmingly, the approach has been education and counseling. This paper calls to action a paradigm shift to a social ecological approach that addresses barriers at all societal levels, especially gender inequality, enabling a much greater impact on mother-to-child transmission of HIV.