Introduction MTCT is the main HIV infection route in Brazilian children. The rates of AIDS detection in children under five years have been decreasing in Brazil since 2004, from 5.6/100,000 inhabitants in 2003 to 2.5/100,000 inhabitants in 2015, with southeast area decreasing fastly and brought the national rate down. To contribute to the reduction in MTC transmission of HIV in Brazil, the Ministry of Health (MoH) launched at the end of 2016 the certification process of cities that eliminated MTCT. The objective of this work is to present the Brazilian process of implementation of HIV MTCT elimination certification.
Methods Experts working group was establish to adapt PAHO criteria to the Brazilian scenario. We included as impact indicators the HIV detection rates among children by birth year; and the proportion of children until 18 months old that were exposed to HIV and was infected, and, in addition must have more than 1 00 000 inhabitants. We analysed data from our national surveillance systems, between 2012 and 2014, to select the municipalities to initiate the process of certification.
Results To be eligible municipalities has to present HIV detection rates≤0.3/1000 live births and/or proportion of children exposed to HIV classified as infected <2%. 3816 out of 5,570 Brazilian municipalities were eligible for certification. Among them 1949 presented the minimum epidemiological criteria to start the certification process, but just 82 metropolises with more than 1 00 000 inhabitants were eligible to start the process.
Conclusion The selected cities must create a multidisciplinary working group to investigate the impact and process indicators established, and need to meet some process indicators that includes prenatal coverage; HIV tests performed during pre-natal among pregnant women; and antiretroviral therapy among infected pregnant. Based on these evidences the cities will receive a certificate of elimination of MTCT HIV. The certification processes is a way to further encourage other municipalities to eliminate MTCT in their territory.