England Nears End of Mother-to-Child HIV Spread: HIV Glasgow 2026

The rate of mother-to-child HIV transmission in England was 0.11% among infants born in 2022–2023 to women diagnosed with HIV by delivery, according to surveillance data presented at HIV Glasgow 2026. Researchers identified one transmission among 928 infants with test results. The rate remained below 0.4% throughout the 2014–2023 study period.

Antenatal Screening and Viral Suppression

The Integrated Screening Outcomes Surveillance Service, part of NHS England’s Infectious Diseases in Pregnancy Screening Programme, follows pregnancies in women with a known HIV diagnosis and their infants. The analysis covered transmissions identified between 2014 and 2023 and calculated the most recent transmission rate for births in 2022–2023. An expert panel reviewed the circumstances around each identified transmission.

The surveillance service recorded 998 live births in 2022–2023. In 87% of cases, the mother had received an HIV diagnosis before pregnancy. Among women with available data, 82% were taking antiretroviral therapy at conception and 92% had a viral load below 50 copies/mL around delivery. England’s antenatal HIV screening coverage was 99.8%, providing another opportunity to identify HIV during pregnancy for women who entered antenatal care without a diagnosis.

Infant test results were available for 93% of the 998 live births. The surveillance programme had confirmed that 911 infants were HIV-negative at the time of the analysis. The estimated transmission rate had a 95% confidence interval of 0.003% to 0.604%, reflecting the uncertainty around a rate based on one observed transmission. The estimate applies to births where the mother’s HIV was diagnosed by delivery and infant test results were available.

Where Transmission Still Occurs

The panel reviewed 16 transmissions identified over the decade. Twelve occurred among infants born to women who knew their HIV status before pregnancy. Eight of those 12 women were taking antiretroviral therapy at conception. The case reviews identified difficulties with treatment adherence or engagement with care, late antenatal booking and likely transmission during breastfeeding without clinical support. In some cases, several factors overlapped, and the timing of transmission was unclear.

Four transmissions occurred among infants born to women diagnosed during pregnancy. In two cases, the mother acquired HIV during pregnancy. The panel identified late antenatal booking in one case and likely transmission during breastfeeding without clinical support in another. These cases illustrate how the circumstances around transmission can vary from pregnancy through the postnatal period.

The findings document sustained low transmission among women with a known diagnosis and show where services can focus as England works towards its 2030 HIV transmission goal. The panel’s findings highlight the value of early antenatal engagement, ongoing support with antiretroviral therapy, and access to clinical advice on infant feeding after delivery.

Reference
Peters H, Francis K, Thorne C. Near-elimination of vertical HIV transmission in England: successes and remaining challenges, 2014–2023. Abstract P001. Presented at: HIV Glasgow 2026; 8–11 November 2026; Glasgow, UK. J Int AIDS Soc. 2026;29(Suppl 6):e70211. doi:10.1002/jia2.70211