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Mother-to-child transmission is the primary route of HIV infection in children under 15 years of age. Since the beginning of the HIV epidemic, an estimated 5.1 million children worldwide have been infected with HIV. Clinical trials in several countries have shown that mother-to-child transmission of HIV can be greatly reduced through administering antiretroviral therapy to pregnant women. These trials culminated in a recommendation by UNAIDS and its partners in the Interagency Task Team for the Prevention of Mother-to-Child Transmission that prevention of perinatal transmission should be a part of the standard package of care for HIV-positive women and their children. Moreover, prevention programs can enhance communities’ response to HIV. In 1999, the Population Council and the International Center for Research on Women initiated activities to identify mechanisms for enhancing community involvement in efforts to prevent mother-to-child transmission. The organizations reviewed the literature on community involvement in the introduction of technologies and assessed community views on preventing mother-to-child transmission in Botswana and Zambia. The literature review provided information about community involvement in earlier introductions of technologies. As noted in this report, that information can guide appropriate and effective community involvement.