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Mother-to-child transmission of HIV continues to be a major cause of infant morbidity and mortality in resource-poor settings. Intrapartum and postpartum nevirapine-based regimens have been introduced in many settings. New research has shown that better efficacy can be achieved with the addition of single-dose nevirapine to short course zidovudine regimens, and that selection of nevirapine-resistant virus can be reduced with a short postpartum combination antiretroviral cover. Women who need antiretroviral therapy for their own health should receive it in pregnancy, and access for pregnant women needs to be expanded urgently. The reduction of transmission through breastfeeding remains a challenge.