Contraception is the best kept secret for prevention of mother-to-child HIV transmission.

We commend Stringer et al. for addressing the importance of developing and implementing a monitoring and evaluation model for measuring the effectiveness of prevention of motherto-child HIV transmission (PMTCT) programmes.1 We also recommend broadening our PMTCT lexicon and developing additional metrics for preventing both HIV acquisition by uninfected women and unintended pregnancies among HIV-infected women. The terms “PMTCT” or “PMTCT programmes” are almost exclusively used to refer to programmes that provide antiretroviral prophylaxis for HIV-infected pregnant women. This is the case despite the 2002 WHO and United Nations’ recommendation of the following comprehensive approach for PMTCT programmes: primary prevention of HIV infec• tion; preventing unintended pregnancies • among HIV-infected women; preventing HIV transmission from • HIV-infected women to their children; and providing care for HIV-infected • mothers and their infants.2