Challenge: Improving retention of breastfeeding women LWHIV on ART

Challenge Summary

This challenge is seeking to Identify effective solutions at the community level to improve retention of mothers living with HIV on ART through pregnancy, delivery, breastfeeding and beyond to prevent mother-to-child transmission of HIV. 

Current Status: Open, accepting Concepts

Challenge Close: Concept deadline: June 30, Full Application deadline: July 14

Prize amount:

Up to £80,000


In Collaboration With: Elizabeth Glaser Paediatric AIDS Foundation & Every Woman Every Child 

Find out more at Positive Action Challenges


While significant global progress has been made in reducing new HIV infections and AIDS-related deaths among newborns and children, critical gaps remain; especially for young women and breastfeeding mothers in developing countries. Breastfeeding is essential to the growth and healthy development of young infants but carries an enormous risk of mother-to-child transmission of HIV when a mother living with HIV is not on sustained antiretroviral therapy (ART). In some countries in sub-Saharan Africa, as few as 50% of pregnant and breastfeeding women living with HIV are retained on ART 12 months after initiation.

In adopting the Sustainable Development Goals, the global community set an ambitious target of ending the AIDS epidemic by 2030. To reach this target, a super-fast-track approach is being implemented to access HIV prevention, treatment, care and support services for children, adolescents and young women. 

Start Free Stay Free AIDS Free is being led by UNAIDS and PEPFAR and aims to end the AIDS epidemic among children, adolescents and young women by 2020. Part of this approach includes a special focus on initiating pregnant women living with HIV on lifelong antiretroviral therapy, while ensuring that breastfeeding mothers are retained in care during the full breastfeeding period.


Initiating and retaining pregnant and breastfeeding women living with HIV on ART is critical to supporting them to stay healthy and prevent the transmission of HIV to their infants. The introduction of lifelong ART for all pregnant women living with HIV in 2013, known as “Option B+,” has significantly increased the number of women receiving ART, from 36% in 2009 to more than 80% in 2015 across 21 priority countries in sub-Saharan Africa. We are therefore seeking innovative solutions to improve the retention of breastfeeding women on ART in resource limited settings where national guidelines support this approach. 

Challenge statement: Identify effective solutions at the community level to improve retention of mothers living with HIV on ART through pregnancy, delivery, breastfeeding and beyond to prevent mother-to-child transmission of HIV.

This may include development of innovative approaches or scale-up of proven interventions. Innovative and novel approaches are particularly encouraged. Solutions may include service delivery methods, adherence/clinical support, educational interventions and/or new technologies but should not contradict national breastfeeding guidelines for women living with HIV.

Success measures may include:

  • Increased retention of women living with HIV on ART during entire period of pregnancy, delivery and breastfeeding
  • Reduced incidence of HIV infection of infants during breastfeeding period by women living with HIV
  • Improved viral suppression of breastfeeding mothers on ART during breastfeeding period
  • Increase in HIV-negative testing status of infants at the end of breastfeeding period




    Click Apply Now to access the PAC Community portal where you can register or log in to start an application. Once registered you can connect with fellow solvers to share ideas, find collaborators and work on applications.
    Submit a Concept Note to provide a summary of your innovation. You can seek input/feedback from other community members or submit right away. Concepts are shortlisted to progress to the next stage by the PAC team based on the challenge criteria.
    The best eligible Concept Notes are invited to submit a Full Application. This stage requires more detail about the development and implementation of your innovation. This is the final stage for applicants before the judging process begins.


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