Ethical considerations in research on preventing mother-to-child HIV transmission

Preventing mother to child transmission of HIV (PMTCT) is an issue that has come to the forefront in the global response to the HIV pandemic. This is particularly true for countries in sub-Saharan Africa and in Asia, which account for the largest proportion of people living with HIV. The relative success of PMTCT efforts to date have encouraged policy makers and donors alike to push for a rapid scaling up of the program in countries with a high prevalence of HIV. However, it is increasingly apparent that the relative success of the program has been at the expense of the rights and well-being of the mothers who are the primary recipients of the intervention. This article examines the nature and scope of the 'research enterprise' in PMTCT and shows how it has influenced intervention design and policy in India. It will also include the voices of 'target' women to convey the extent to which the research has impacted on their lives. Finally, this article indicates priorities for research that can help the situation of women as well as reduce MTCT of HIV.