Significant progress has been achieved in decreasing prenatal human immunodeficiency virus (HIV) transmission in the United States and across the world. Despite these advances, avoidable prenatal HIV transmission remains. Adherence to HIV screening and treatment guidelines before and throughout pregnancy can lower the risk of perinatal HIV transmission significantly. Early and regular use of highly active antiretroviral treatment (ART) can significantly reduce HIV viral load, reducing the risk of HIV transmission.
Additional intrapartum treatments can lower the risk of HIV transmission even more. Although the current standard is to recommend abstinence from breastfeeding for people living with HIV in settings where there is safe access to breast milk alternatives (such as the United States), there is guidance available on counselling and risk-reduction strategies for people on ART who choose to breastfeed despite having an undetectable viral load.