Changes to PMTCT treatment regimens over the past five years have played a major part in the impressive decline in vertical transmission rates. In 2010, the majority of pregnant women living with HIV were provided with ARVs solely to prevent onward transmission to the child they were carrying at the time. But evidence suggested that immediate and lifelong ART for pregnant women diagnosed with HIV is more effective than on-again, off-again approaches. In 2015, the World Health Organisation (WHO) recommended that all pregnant women living with HIV be provided with Option B+, which involves the immediate offer of lifelong ART—going beyond pregnancy, delivery and breastfeeding—regardless of CD4 count (which indicates the level of HIV in the body). By 2015, 91% of the 1.1 million women receiving ARVs to prevent MTCT were on lifelong ART due to the global rollout of Option B+. This greatly improved rates of viral suppression, when HIV is reduced to such a low level that onward transmission is highly unlikely, during both the breastfeeding period and afterwards for these women.
Some gains were also made in the efforts to prevent unintended pregnancies in countries with large numbers of paediatric HIV infections, although an unmet need for family planning still persists in many countries. Between the periods of 2000–2004 and 2010–2014, unmet needs for family planning among married women declined by more than 10% in Ethiopia, Kenya, Lesotho, Malawi and Rwanda. Among the countries with available data in sub-Saharan Africa, Zimbabwe had the lowest unmet need for family planning among married women (10%
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