Program and policy interventions for preventing mother-to-child transmission of HIV in New York State.

Mother-to-child transmission (MTCT) of human immunodeficiency virus has been virtually eliminated in New York State (NYS) in a relatively short time. The dramatic reduction in MTCT was achieved through a comprehensive public health program that maximized the benefits of advances in both diagnosis and treatment of HIV infection. The multifaceted program encompassed interventions at multiple levels. It mobilized and engaged medical providers, and it changed clinical practice and the health care delivery system in NYS. Specific approaches were developed and modified over time by using data from multiple sources and in response to medical and scientific advances. This article describes factors associated with MTCT in NYS, the framework for program development, the evolution of NYS's public health program to prevent MTCT, remaining issues, and recommendations.