KIU Publications

HIV/AIDS remains a major public health challenge in East Africa despite substantial progress in prevention of mother-to-child transmission (PMTCT) and antiretroviral therapy (ART) scale-up. Women of reproductive age constitute a disproportionately affected population, with significant implications for maternal morbidity, mortality, and child health outcomes. This review synthesizes current evidence on the epidemiology, biological mechanisms, and clinical consequences of HIV infection during pregnancy in East Africa. It further examines vertical transmission, adverse birth outcomes, pediatric HIV, and long-term developmental consequences in HIV-exposed uninfected (HEU) children. Although ART expansion has dramatically reduced mother-to-child transmission (MTCT), persistent gaps remain in retention in care, viral suppression, adolescent pregnancy, and socio-structural inequities. Strengthening integrated maternal–child health (MCH) services, optimizing ART adherence, and addressing health system barriers are critical to improving outcomes in the region.