PIP: In Africa, about 30% of all infants born to HIV-infected mothers become infected with HIV. About 4 million women of reproductive age in Africa are infected with HIV. Africa lacks HIV counseling and testing facilities. Family sizes are large. Asia has paid less attention to perinatal transmission than has Africa. Heterosexual transmission is also the predominant mode of HIV infection in Asia. Interventions that might prevent perinatal transmission have recently emerged. HIV/AIDS programs, maternal and child health (MCH) programs, and family planning providers must collaborate to reduce perinatal transmission. HIV/AIDS, MCH, and reproductive health specialists; women's health advocates; and pregnant women must discuss complex policy and ethics issues as they consider interventions. Women in developing countries familiar with their HIV status would arrive at more informed decisions about reproduction than those ignorant of their HIV status. Rapidly falling prices of HIV tests may mean access to testing for more women in developing countries. Availability of safe, effective contraception and abortion services would contribute to the success of counseling and testing to reduce the number of births at risk of perinatal transmission. In areas where infectious diseases and malnutrition cause most infant deaths, mothers should breast feed regardless of HIV status. In areas where this is not the case, mothers should use breast milk substitutes. Some evidence suggests that cesarean sections reduce the rate of perinatal transmission. Vaginal cleansing before and during labor may also reduce it. Since maternal vitamin A deficiency may facilitate perinatal transmission, vitamin A supplementation in pregnant women may reduce the risk of perinatal transmission. Administration of zidovudine to HIV-infected pregnant women reduced the risk of perinatal transmission by 67% in a recent clinical trial.