Miranda Angelica Espinosa, Pereira Gerson Fernando Mendes, Araujo Maria Alix Leite, Silveira Mariangela Freitas da, Tavares Leonor De Lannoy, Silva Leila Cristina Ferreira da, Moreira-Silva Sandra Fagundes, Saraceni Valéria
Universidade Federal do Espírito Santo, Vitória, Brasil.
Departamento Nacional de DST, AIDS e Hepatites Virais, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Brasil.
Cad Saude Publica. 2016 Sep 19;32(9):e00118215. doi: 10.1590/0102-311X00118215.
This study aimed to assess the cascade of care in the reduction of mother-to-child HIV transmission in the states of Amazonas, Ceará, Espírito Santo, Rio de Janeiro, and Rio Grande do Sul and the Distrito Federal, Brazil, using data from the Brazilian Information System on Diseases of Notification (SINAN). From 2007 to 2012, there was an increase (from 7.3% in Distrito Federal to 46.1% in Amazonas) in intra-gestational detection of HIV in 5 states, with a 18.6% reduction in Rio de Janeiro. Fewer than 90% of the women received antiretroviral therapy during their prenatal care, including those that already knew they were HIV-positive. The elective cesarean rate was low. The AIDS detection rate in children under 5 years as a proxy for mother-to-child HIV transmission showed a reduction of 6.3% from 2007 to 2012, and was highest in Rio Grande do Sul (50%), the state with the highest rates in the period, while Espírito Santo showed the highest increase (50%). Evaluation of the cascade of HIV care in pregnant women identified flaws in all the points. A link is needed between primary care and referral centers for HIV/AIDS, organizing care for the family and better outcomes for the children.
本研究旨在利用巴西疾病通报信息系统（SINAN）的数据，评估巴西阿马帕州、塞阿拉州、圣埃斯皮里图州、里约热内卢州、南里奥格兰德州和联邦区在减少母婴传播艾滋病毒方面的连续医疗服务情况。2007年至2012年期间，5个州孕期艾滋病毒检测率有所上升（从联邦区的7.3%升至阿马帕州的46.1%），里约热内卢州下降了18.6%。在产前护理期间，包括那些已知自己感染艾滋病毒的妇女在内，接受抗逆转录病毒治疗的妇女不到90%。选择性剖宫产率较低。以5岁以下儿童的艾滋病检测率作为母婴传播艾滋病毒的替代指标，2007年至2012年期间下降了6.3%，南里奥格兰德州最高（50%），该州在此期间发病率最高，而圣埃斯皮里图州上升幅度最大（50%）。对孕妇艾滋病毒连续医疗服务的评估发现各环节均存在缺陷。初级保健与艾滋病毒/艾滋病转诊中心之间需要建立联系，为家庭组织医疗服务并为儿童带来更好的结果。
