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

By Elaine da Silva Pires Araujo, Ruth Khalili Friedman, Luis Antonio Bastos Camacho, Monica Derrico, Ronaldo Ismério Moreira, Guilherme Amaral Calvet, Marília Santini de Oliveira, Valdilea Gonçalves Veloso, José Henrique Pilotto and Beatriz Gilda Jegerhorn Grinsztejn


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

Topics: HIV, Infectious Disease Transmission, Vertical/prevention & control, Anti-Retroviral Agents/immunology, Chemoprevention, Cohort Studies, Brazil
Publisher: Elsevier
Year: 2014
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