{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:18:38Z","timestamp":1787501918931,"version":"build-2736575974"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T00:00:00Z","timestamp":1745798400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000092","name":"U.S. National Library of Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000092","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Antiretroviral therapy (ART) during pregnancy and at delivery has nearly eliminated vertical transmission (VT) in some settings but previously reported VT prevalence has been as high as 15% in Latin America and the Caribbean (LAC). We evaluated VT in the Caribbean, Central and South America network for HIV epidemiology to further study the benefit of ART on VT in our region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively collected data on cis\u2010gender women \u226515 years of age enrolled in HIV clinics in Brazil, Chile, Honduras and Peru from 2003 to 2018 with \u22651 pregnancy resulting in a live birth after clinic entry to examine the association of ART use at the time of delivery and VT. We used propensity\u2010score\u2010matched logistic regression to examine the odds of VT by ART use. Matching weights incorporated site, HIV RNA, CD4 cell count, maternal age, year and HIV diagnosis before or during pregnancy. We also examined the proportion of women who received ART during pregnancy before and after the treat\u2010all era, as defined within each country.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 623 pregnant women with HIV contributed 727 live births. Of all births, 613 (84.3%) infants had known HIV status and there were 22 (3.6%) VT events. Four of the 22 (18%) were born to women on ART at delivery, compared to 403 of 591 (68%) infants negative for HIV. In the propensity\u2010score\u2010matched model, ART use at delivery was associated with 85% decreased odds of VT (odds ratio = 0.15, 95% confidence interval 0.04\u22120.58). In the pre\u2010treat\u2010all era, 37% (181\/485) of women received ART within 30 days of pregnancy diagnosis, compared to 59% (75\/128) during the treat\u2010all era (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001). In the pre\u2010treat\u2010all era, 4.3% (21\/485) of infants were born HIV positive, compared to 0.8% (1\/128) in the treat\u2010all era (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.055).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We found a low prevalence of VT in our cohort, especially in the treat\u2010all era. ART use at delivery was strongly associated with a lower odd of VT. Despite improvements, access to ART during pregnancy remained far from universal. Therefore, new strategies to ensure its effective implementation in LAC are still warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.26411","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T06:41:31Z","timestamp":1745822491000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["ART to prevent vertical transmission in Latin America: where are we in the \u201cTreat\u2010All\u201d era?"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7344-3423","authenticated-orcid":false,"given":"Gabriel","family":"Castillo\u2010Rozas","sequence":"first","affiliation":[{"name":"Faculty of Medicine Universidad de Chile  Santiago Chile"},{"name":"Hospital Clinico San Borja Arriaran &amp; Fundaci\u00f3n Arriaran  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5403-181X","authenticated-orcid":false,"given":"Fernanda F.","family":"Fonseca","sequence":"additional","affiliation":[{"name":"AIDS HealthCare Foundation, Global Program  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7599-8173","authenticated-orcid":false,"given":"Jessica","family":"Castilho","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1951-9104","authenticated-orcid":false,"given":"Peter F.","family":"Rebeiro","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1993-6442","authenticated-orcid":false,"given":"Daisy M.","family":"Machado","sequence":"additional","affiliation":[{"name":"UNIFESP, Escola Paulista de Medicina, Disciplina de Infectologia Pedi\u00e1trica  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6868-4435","authenticated-orcid":false,"given":"Marco Tulio","family":"Luque","sequence":"additional","affiliation":[{"name":"Hospital Escuela Universitario  Tegucigalpa Honduras"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6017-5660","authenticated-orcid":false,"given":"Emilia M.","family":"Jalil","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Infectologia \u2010 Evandro Chagas, Fiocruz  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8429-8833","authenticated-orcid":false,"given":"Fernando","family":"Mejia","sequence":"additional","affiliation":[{"name":"Instituto de Medicina Tropical Alexander von Humboldt Universidad Peruana Cayetano Heredia  Lima Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4510-7453","authenticated-orcid":false,"given":"Ahra","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3758-5992","authenticated-orcid":false,"given":"Bryan E.","family":"Shepherd","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9101-9783","authenticated-orcid":false,"given":"Claudia P.","family":"Cortes","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Universidad de Chile  Santiago Chile"},{"name":"Hospital Clinico San Borja Arriaran &amp; Fundaci\u00f3n Arriaran  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,28]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199411033311801"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.26032"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00042560-199504120-00011"},{"key":"e_1_2_12_5_1","unstructured":"UNICEF data: elimination of mother\u2010to\u2010child transmission. 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