Cascade of access to interventions to prevent HIV mother to child transmission in the metropolitan area of Rio deJaneiro, Brazil

Abstract

Objectives: To describe the access to the interventions for the prevention of Human Immun-odeficiency Virus (HIV) mother to child transmission and mother to child transmission ratesin the outskirts of Rio de Janeiro, from 1999 to 2009.Methods: This is a retrospective cohort study. Prevention of HIV mother to child transmissioninterventions were accessed and mother to child transmission rates were calculated.Results: The study population is young (median: 26 years; interquartile range: 22.0–31.0), withlow monthly family income (40.4% up to one Brazilian minimum wage) and schooling (62.1%less than 8 years). Only 47.1% (n = 469) knew the HIV status of their partner; of these women,39.9% had an HIV-seronegative partner. Among the 1259 newborns evaluated, access to theantenatal, intrapartum and postpartum prevention of HIV mother to child transmissioncomponents occurred in 59.2%, 74.2%, and 97.5% respectively; 91.0% of the newborns werenot breastfed. Overall 52.7% of the newborns have benefited from all the recommendedinterventions. In subsequent pregnancies (n = 289), 67.8% of the newborns received the fullpackage of interventions. The overall rate of HIV vertical transmission was 4.7% and thehighest annual rate occurred in 2005 (7.4%), with no definite trend in the period.Conclusions: Access to the full package of interventions for the prevention of HIV verticaltransmission was low, with no significant trend of improvement over the years. The verti-cal transmission rates observed were higher than those found in reference services in themunicipality of Rio de Janeiro and in the richest regions of the country