Interventions to prevent vertical transmission of HIV: an umbrella review of systematic reviews and meta-analyses

The aim of this umbrella review of systematic reviews and meta-analyses was to systematically consolidate and evaluate the existing evidence on interventions aimed at preventing vertical transmission of HIV, with a specific focus on assessing their efficacy and clinical applicability. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, PubMed, Cochrane Library, and Embase were searched for systematic reviews and meta-analyses (up to Feb 2025). Two reviewers independently screened studies and extracted data, including intervention outcomes. Twenty-three systematic reviews and meta-analyses were synthesized, categorizing interventions into seven types: antiretroviral therapy (ART) (n = 7), cesarean delivery (n = 1), vitamins (n = 2), vaginal disinfection (n = 2), partner engagement (n = 3), telemedicine (n = 1), and integrated approaches (n = 7). Based on this, we conclude that ART demonstrated the strongest efficacy to suppress vertical transmission of HIV. Cesarean delivery reduced transmission risk but increased postpartum morbidity. Vitamins and vaginal disinfection had minimal impact. Telemedicine may improve adherence to prevention protocols. Integrated strategies combining ART showed enhanced effectiveness in low-resource settings. In conclusion, the evidence reported in this umbrella review suggests that ART therapy supplemented by other preventive measures is an effective way to reduce the rate of mother to child transmission of HIV. Vitamin supplement and vaginal disinfection had no clear association with the risk of vertical transmission of HIV.