{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T11:10:10Z","timestamp":1751368210608,"version":"3.41.0"},"reference-count":8,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:00:00Z","timestamp":1748217600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Vertical transmission of HIV remains a critical and preventable aspect of the global HIV epidemic. Despite significant advancements in antiretroviral therapy (ART) and prevention strategies reducing mother\u2010to\u2010child transmission (MTCT) worldwide, a concerning disparity persists between what is medically achievable and the reality experienced in many communities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This manuscript reviews the current landscape of MTCT of HIV, drawing on documented successes in elimination and identifying persistent barriers. It analyzes challenges related to therapeutic options for neonates, pharmaceutical supply chains, regulatory approval processes for neonatal ART, and the socio\u2010ethical dimensions. Based on this analysis, a comprehensive five\u2010point action plan is proposed to address these multifaceted issues.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The review highlights that 19 countries and territories have successfully eliminated MTCT of HIV, demonstrating the feasibility of this goal. However, significant barriers impede universal success. These include: 1) Limited availability of neonatal\u2010specific ART formulations. 2) Pharmaceutical market dynamics driven by high\u2010income countries. 3) Ethical and regulatory hurdles in conducting clinical trials for ART in neonates, hindering the generation of safety data. 4) MTCT is not just a medical problem but a profound social justice issue, exacerbated by stigma and discrimination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Elimination of vertical HIV transmission is an attainable goal. The proposed action plan\u2013encompassing strengthened antenatal screening, prompt ART initiation for pregnant women, guaranteed neonatal prophylaxis, robust supply chain management, and dedicated research and advocacy\u2013offers a pathway to extend the possibility of an HIV\u2010free start in life to every child, regardless of geographic or economic circumstance.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.70052","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T04:39:03Z","timestamp":1748320743000},"page":"1157-1159","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The silent crisis: Vertical <scp>HIV<\/scp> transmission and the struggle for antiretroviral access"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1222-1930","authenticated-orcid":false,"given":"P\u00e9rez\u2010Cavazos","family":"Samantha","sequence":"first","affiliation":[{"name":"Servicio de Infectolog\u00eda Hospital Universitario \u201cDr. Jos\u00e9 Eleuterio Gonz\u00e1lez\u201d Avenida Francisco I. Madero  Mitras Centro M\u00e9xico"},{"name":"Universidad Aut\u00f3noma de Nuevo Le\u00f3n  Monterrey M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6642-2770","authenticated-orcid":false,"given":"P\u00e9rez\u2010Alba","family":"Eduardo","sequence":"additional","affiliation":[{"name":"Servicio de Infectolog\u00eda Hospital Universitario \u201cDr. Jos\u00e9 Eleuterio Gonz\u00e1lez\u201d Avenida Francisco I. Madero  Mitras Centro M\u00e9xico"},{"name":"Universidad Aut\u00f3noma de Nuevo Le\u00f3n  Monterrey M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8044-0094","authenticated-orcid":false,"given":"Camacho\u2010Ortiz","family":"Adri\u00e1n","sequence":"additional","affiliation":[{"name":"Servicio de Infectolog\u00eda Hospital Universitario \u201cDr. Jos\u00e9 Eleuterio Gonz\u00e1lez\u201d Avenida Francisco I. Madero  Mitras Centro M\u00e9xico"},{"name":"Universidad Aut\u00f3noma de Nuevo Le\u00f3n  Monterrey M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,5,26]]},"reference":[{"key":"e_1_2_1_4_2_1","unstructured":"Belice Jamaica y San Vicente y las Granadinas eliminan la transmisi\u00f3n maternoinfantil del VIH y la s\u00edfilis \u2013 OPS\/OMS | Organizaci\u00f3n Panamericana de la Salud [Internet].2024. February 27 2025.https:\/\/www.paho.org\/es\/noticias\/7\u20105\u20102024\u2010belice\u2010jamaica\u2010san\u2010vicente\u2010granadinas\u2010eliminan\u2010transmision\u2010maternoinfantil\u2010vih"},{"key":"e_1_2_1_4_3_1","article-title":"HIV prophylaxis in high risk newborns: an examination of sociodemographic factors in an Inner City context","volume":"2016","author":"Alidina Z","year":"2016","journal-title":"Can J Infect Dis Med Microbiol J Can Mal Infect Microbiol M\u00e9dicale"},{"key":"e_1_2_1_4_4_1","doi-asserted-by":"publisher","DOI":"10.4102\/sajhivmed.v16i1.375"},{"key":"e_1_2_1_4_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(22)00121-7"},{"key":"e_1_2_1_4_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40272-024-00656-4"},{"key":"e_1_2_1_4_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.26032"},{"key":"e_1_2_1_4_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000001224"},{"key":"e_1_2_1_4_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-019-4137-7"}],"container-title":["HIV Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.70052","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T10:45:27Z","timestamp":1751366727000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hiv.70052"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,26]]},"references-count":8,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1111\/hiv.70052"],"URL":"https:\/\/doi.org\/10.1111\/hiv.70052","archive":["Portico"],"relation":{},"ISSN":["1464-2662","1468-1293"],"issn-type":[{"type":"print","value":"1464-2662"},{"type":"electronic","value":"1468-1293"}],"subject":[],"published":{"date-parts":[[2025,5,26]]},"assertion":[{"value":"2025-04-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}