In this week's PLoS Medicine, Andrea Ciaranello of Massachusetts General Hospital, Boston, USA and colleagues find, using a simulation model, that implementation of the latest WHO PMTCT (prevention of mother to child transmission of HIV) guidelines must take place in conjunction with improving access to PMTCT programs, increasing retention of women in care, and supporting adherence to drugs, in order to eliminate pediatric HIV in Zimbabwe.

The authors say: "Although PMTCT uptake in low- and middle-income countries has risen remarkably, from 10% in 2004 to 53% in 2009, greater access to care and medications for HIV-infected pregnant women is still needed...A focused operational research agenda is critical to identify, implement, and evaluate interventions that improve uptake and retention at each step in the PMTCT cascade."