Kerr Ligia Regina Franco Sansigolo, Cavalcante Maria do Socorro, Kendall Carl, Machado Márcia M, Dourado Maria Inês, Galvao Marli
Departamento de Saude Comunitária, Universidade Federal do Ceará, Fortaleza, Brazil.
AIDS Care. 2011 Jun;23(6):771-4. doi: 10.1080/09540121.2010.532534.
Perinatal HIV prevention has been successful in developing countries but disparities in success between rich countries and poor countries have also been observed. Access to prevention of mother-to-child transmission (PMTCT) remains a challenge in many developing countries. In 2007, the Ministry of Health launched the Plan to Reduce the Vertical Transmission of HIV and Syphilis in Brazil to address this need. A cross-sectional study of children living in families affected by HIV was conducted in Ceara State, Northeast Brazil between June 2008 and January 2009 to explore socioeconomic effects of HIV status. Proportion of children with an HIV-positive test was calculated and stratified by age to estimate the impact of PMTCT programs. Chi-square test was employed to compare those proportions. Stata™10.0 software was used for the calculation. We interviewed 437 adults who were visiting the hospital for a consultation or to pickup medication who also had a child less than 13 years of age living with them. They also provided information about other household members (n=1789). Our study showed that children infected with HIV or who live in a household with one or both parents infected with HIV or dead from AIDS live in families of low social class and educational achievement. Seroprevalence is not lower in the cohort of those children 0-2 as compared to 3-4 and 5-12 years of age. Even in Brazil, with its successful PMTCT program overall, there are great disparities among sites. Data from the sites reported here are equivalent to many poor areas in sub-Saharan Africa. This argues that global concern for targeting areas most affected by the epidemic must consider areas within some of the most prosperous countries in the world.
围产期艾滋病毒预防在发展中国家已取得成功，但富国和穷国之间在这方面的成效也存在差异。在许多发展中国家，获得预防母婴传播（PMTCT）服务仍然是一项挑战。2007年，巴西卫生部启动了减少艾滋病毒和梅毒垂直传播计划，以满足这一需求。2008年6月至2009年1月期间，在巴西东北部塞阿拉州对受艾滋病毒影响家庭中的儿童进行了一项横断面研究，以探讨艾滋病毒感染状况的社会经济影响。计算艾滋病毒检测呈阳性儿童的比例，并按年龄分层，以评估预防母婴传播项目的影响。采用卡方检验比较这些比例。使用Stata™10.0软件进行计算。我们采访了437名到医院咨询或取药的成年人，他们都有一名13岁以下的孩子与他们同住。他们还提供了其他家庭成员的信息（n = 1789）。我们的研究表明，感染艾滋病毒或生活在父母一方或双方感染艾滋病毒或死于艾滋病家庭中的儿童，其家庭社会阶层和教育程度较低。0 - 2岁儿童队列中的血清阳性率与3 - 4岁和5 - 12岁儿童相比并不低。即使在总体上预防母婴传播项目取得成功的巴西，不同地区之间也存在巨大差异。此处报告的地区数据与撒哈拉以南非洲的许多贫困地区相当。这表明，全球对最受该流行病影响地区的关注必须考虑世界上一些最繁荣国家内部的地区。
