Ihe scientific literature concerning maternal-foetal HIV transmission was reviewed to determine current policy options. Reproductive options for women with HIV include increasing the number of pregnancies to ensure survival of some children, renouncing pregnancy, seeking abortion, and continuing with a pregnancy already underway. For policy makers, options include counselling and testing high risk women, routinely offering HIV testing to all women preconceptually or prenatally, performing routine newborn antibody screening via heelprick, and screening newborns using dried blood spot polymerase chain reaction confirmation. Each of these policy options presents financial cost implications, social repercussions, ethical dilemmas, and reflects culture-bound interactions between the status of women and reproductive decision-making.