BackgroundIn 2010, an estimated 141 new HIV infections occurred per day in Cameroon and reports suggest an upsurge of these rates by 2020 if current trends continue. Mother—to—child transmission (MTCT) of HIV is a major public health challenge, and maternal knowledge on HIV transmission during pregnancy and its prevention is important in curtailing paediatric HIV acquisition.ObjectivesWe aimed at establishing the prevalence of maternal HIV infection as well as assessing knowledge on HIV, MTCT and prevention of MTCT (PMTCT) of HIV among pregnant women in a rural area of Cameroon.MethodsThis study was conducted in two phases: a 29 month retrospective analysis of 1866 deliveries within three rural health facilities in the Babessi sub—division, Northwest Cameroon and a 1 month prospective phase wherein 150 consenting pregnant women attending antenatal care (ANC) at the study centres were consecutively recruited.ResultsOverall, the prevalence of maternal HIV infection was 5.0% (100/2016). All (100%) of the interviewed pregnant women were aware of HIV infection and most (76.7%) had adequate knowledge on its routes of transmission. Meanwhile, only 79.3% (119/150) of them were aware of MTCT with slightly above a third (37.0%) having adequate knowledge on the periods of transmission. The proportions of women correctly stating: during pregnancy, during labour/delivery and during breastfeeding as possible periods of MTCT of HIV were 63.0%, 60.5% and 89.1% respectively. A majority (76.3%) of these women had inadequate knowledge on PMTCT of HIV.ConclusionThe overall prevalence of maternal HIV warrants strengthening of current intervention strategies including scaling—up of PMTCT measures. Among others, intensification of HIV—related ANC services to improve the pregnant women’s awareness and knowledge on MTCT and its prevention are vital steps in curbing the growing burden of paediatric HIV.