Abstract
This retrospective cohort study from Rwanda demonstrated the likelihood of maternal disclosure and peer support in preventing mother-to-child human immunodeficiency virus (HIV) transmission. High sustained maternal viral load suppression (91.0%) and exceptional infant testing uptake (100% at 6 weeks) correlated with a low 0.7% infant HIV incidence. To eliminate mother-to-child transmission of HIV, effective strategies must engage male partners in disclosure, reduce stigma, improve health literacy, and provide structural peer-support for enhancing adherence and mental health.