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Translating Research Into Policy and Practice

Kevin M. De Cock, MD; Mary Glenn Fowler, MD, MPH; Eric Mercier, MD, MPH; Isabelle de Vincenzi, MD, PhD; Joseph Saba, MD; Elizabeth Hoff, MSc; David J. Alnwick, MSc; Martha Rogers, MD; Nathan Shaffer, MD

JAMA. 2000;283:1175-1182.

Each year, an estimated 590,000 infants acquire human immunodeficiency virus type 1 (HIV) infection from their mothers, mostly in developing countries that are unable to implement interventions now standard in the industrialized world. In resource-poor settings, the HIV pandemic has eroded hard-won gains in infant and child survival. Recent clinical trial results from international settings suggest that short-course antiretroviral regimens could significantly reduce perinatal HIV transmission worldwide if research findings could be translated into practice. This article reviews current knowledge of mother-to-child HIV transmission in developing countries, summarizes key findings from the trials, outlines future research requirements, and describes public health challenges of implementing perinatal HIV prevention interventions in resource-poor settings. Public health efforts must also emphasize primary prevention strategies to reduce incident HIV infections among adolescents and women of childbearing age. Successful implementation of available perinatal HIV interventions could substantially improve global child survival.

Author Affiliations: Division of HIV/AIDS Prevention—Surveillance and Epidemiology, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Ga (Drs De Cock, Fowler, Rogers, and Shaffer); Programme Division, United Nations Children's Fund, New York, NY (Dr Mercier and Mr Alnwick); Department of Policy, Strategy, and Research, Joint United Nations Programme on HIV/AIDS (UNAIDS), (Drs de Vincenzi and Saba); Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland (Ms Hoff).

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