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This double-blind, randomized trial in Botswana compared two highly active antiretroviral regimens in HIV-1−infected pregnant women (CD4+ count, ≥200) from pregnancy through 6 months post partum (when breast-feeding ceased). Both regimens were highly effective in suppressing the maternal HIV-1 viral load as well as mother-to-child transmission, with an overall transmission rate of 1.1%. Highly active antiretroviral therapy (HAART) used to prevent in utero and intrapartum mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1) is among the most successful public health interventions of the HIV era. 1 , 2 However, the use of HAART in mothers to prevent mother-to-child transmission through breast-feeding in areas of the world where replacement feeding is neither safe nor feasible remains an unproven strategy. 1 , 3 We compared different HAART regimens used in pregnancy and during breast-feeding to determine whether the regimens differ with respect to virologic suppression during pregnancy and breast-feeding, pregnancy outcomes, and toxic effects in mothers and infants. . . .