In children HIV is usually spread from a mother to her fetus or young infant. This is called mother-to-child transmission or MTCT. An HIV-infected mother may pass the virus to her child by the following routes:
- HIV may cross the placenta from the mother to her fetus during pregnancy.
- The infant may be infected with HIV by contact with vaginal secretions and blood during labour and delivery.
- HIV may cross to the infant in breast milk.
- Young children may also be infected with HIV during rape or sexual assault while adolescents may be infected during consenting intercourse.
- Children may be infected when sharp instruments are used in ritual scratching or scarification or circumcision if the instrument is contaminated with blood containing HIV from another person.