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孕妇中 HIV 的流行病学及其与 COVID-19 大流行期间的关系。

Epidemiology of HIV in pregnant women and its relationship with the period of the COVID-19 pandemic.

机构信息

Universidade Federal do Ceará, Departamento de Enfermagem, Programa de Pós-graduação em Enfermagem, Fortaleza, CE, Brazil.

出版信息

Rev Esc Enferm USP. 2023 Mar 27;57:e20220339. doi: 10.1590/1980-220X-REEUSP-2022-0339en. eCollection 2023.

Abstract

OBJECTIVE

To analyze, in the light of the Social Ecological Theory, the progression of reported cases of HIV during pregnancy in a Brazilian state and their relationship with the onset of the COVID-19 pandemic.

METHOD

Retrospective study, with a sample consisting of all reports of gestational HIV in the state of Ceará - Brazil from 2017 to 2021, on the IntegraSUS platform. Data collection was carried out in January 2022. The analyzed variables were organized according to the theoretical levels: macrosystem, exosystem, mesosystem, and microsystem.

RESULTS

A total of 1,173 cases of HIV in pregnant women were recorded. When comparing the pre- and post-pandemic period, a reduction in the disease detection rate (from 231 to 122.67 pregnant women) was observed, as well as 1.82 times more chances of women not using antiretrovirals during childbirth after the start of the pandemic. There was a 55% reduction in vaginal births and 39% in cesarean sections among women diagnosed with HIV after the start of the pandemic.

CONCLUSION

The COVID-19 pandemic had an epidemiological and care impact, leading to a reduction in the number of notifications and in the detection rate of pregnant women living with HIV in the state of Ceará. Therefore, the need to ensure health care coverage is emphasized, with early diagnosis actions, guaranteed treatment, and quality prenatal care.

摘要

目的

根据社会生态学理论分析巴西某州妊娠期 HIV 报告病例的进展及其与 COVID-19 大流行开始的关系。

方法

回顾性研究,样本为 2017 年至 2021 年期间巴西塞阿拉州 IntegraSUS 平台上所有的妊娠期 HIV 报告。数据收集于 2022 年 1 月进行。分析的变量根据理论层面进行组织:宏系统、外系统、中系统和微系统。

结果

共记录了 1173 例孕妇 HIV 病例。与大流行前相比,疾病检出率降低(从 231 例降至 122.67 例孕妇),大流行开始后,分娩时不使用抗逆转录病毒药物的孕妇机会增加了 1.82 倍。大流行开始后诊断出 HIV 的女性中,阴道分娩减少了 55%,剖宫产减少了 39%。

结论

COVID-19 大流行对流行病学和护理产生了影响,导致塞阿拉州报告的 HIV 孕妇数量和检出率下降。因此,需要强调确保医疗保健覆盖,采取早期诊断措施,保证治疗和优质的产前护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79bd/10081587/3d42826c0964/1980-220X-reeusp-57-e20220339-gf01.jpg

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