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P3.222 Factors associated with maternal-child transmission of HIV-1 in southeastern brazil: a retrospective study
  1. Thiago Nascimento Do Prado1,
  2. Debbie Bain Brickley2,
  3. Nancy Hills2,
  4. Jefferson Vitorino Cantão De Souza1,
  5. Sandra Fagundes Moreira Da Silva3,
  6. Eliana Zandonade1,
  7. Angélica Espinosa Miranda1
  1. 1Universidade Federal do Espírito Santo, Vitória – ES, Brazil
  2. 2University of California (UCSF), San Francisco, USA
  3. 3Serviço de Infectologia, Hospital Infantil Nossa Senhora da Glória, Vitória – ES, Brazil

Abstract

Introduction Mother-to-child transmission (MTCT) is the main mode of acquisition of HIV-1 among young children worldwide. In Brazil, the southeast region is the geographical area that reports the majority of MTCT cases. The goals of this study were to estimate the rate of HIV MTCT and to identify factors associated with MTCT in Espírito Santo State, in southeast Brazil.

Methods This study was a review of the data from the Brazilian National Information on Reportable Diseases System (SINAN) for HIV-infected pregnant women and for AIDS among children under 13 years old. The study population was comprised of all HIV-infected pregnant women reported to SINAN in the State of Espírito Santo, Brazil between January 1, 2007 and December 31, 2012.

Results A total of 470 women were included in the study. The proportion of MTCT during this period was 14.0% (95% CI 10.9–17.0). In a multivariable logistic regression model incorporating the significant covariates identified in bivariate analyses, women who had less than primary school education had increased odds of MTCT (OR=2.64; 95% CI 1.34–5.22) compared to women with more than primary school education. Emergency caesarean delivery was associated with increased odds of MTCT (OR=4.40; 95% CI 1.12–17.08) compared to vaginal delivery. In addition, pregnant women who did not receive ART during prenatal care had higher odds of MTCT (OR=2.21; 95% CI 1.10–4.47) compared to pregnant women who received ART during prenatal care.

Conclusion Health information systems can provide the basis for monitoring and analysing the health situation in municipalities and states, with a view towards health planning and management. This study identified a high rate of HIV MTCT in Espírito Santo State and effort should be made to encourage health care workers and pregnant women to use MTCT prevention services.

Support: University of California, San Francisco’s International Traineeships in AIDS Prevention Studies (ITAPS), U.S. NIMH, R25MH064712

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