Domingues Rosa Maria Soares Madeira, Dias Marcos Augusto Bastos, Esteves-Pereira Ana Paula, Luz Paula Mendes, Jalil Emilia, Rocha Vania, Rabello Angela Cristina Vasconcelos de Andrade, Friedman Ruth Khalili, Leal Maria do Carmo
Fundação Oswaldo Cruz, Evandro Chagas National Institute of Infectious Diseases - Rio de Janeiro (RJ), Brazil.
Fundação Oswaldo Cruz, Fernandes Figueira National Institute for Women, Children and Adolescents' Health - Rio de Janeiro (RJ), Brazil.
Rev Bras Epidemiol. 2025 May 9;28:e250020. doi: 10.1590/1980-549720250020. eCollection 2025.
To estimate the prevalence of HIV infection in pregnant women; analyze the gestational and maternal outcomes of women with HIV; and evaluate process indicators for the prevention of vertical transmission of HIV according to type of financing for hospital admission in the state of Rio de Janeiro (RJ).
cross-sectional study with 1,923 women, conducted between 2021-2023. Interviews were carried out with women, and data was extracted from the pregnancy booklet and hospital records. The prevalence of HIV infection, gestational and maternal outcomes, and the adequacy of process indicators for the management of HIV infection were estimated with respective 95% confidence intervals (95%CI) according to the type of financing - public or private - for hospital admission for childbirth or abortion.
Coverage of prenatal care (PNC), HIV testing during PNC (one and two tests), and testing during hospital admission was 93.7, 79.7, 45.8, and 79.2%, respectively. The prevalence of HIV infection was estimated at 0.79% (95%CI 0.31-1.99). Only 40% of women with HIV had registered antiretroviral treatment and 26% had registered viral load tests in their pregnancy booklet. Women with public funding were more socially vulnerable and had less coverage of PNC and testing with two tests.
Missed opportunities were identified in the management of pregnant women with HIV in public and private services in RJ. The detection rate was higher than that of the Notifiable Diseases Information System and suggests underreporting of cases.
估计孕妇中艾滋病毒感染的流行率；分析感染艾滋病毒妇女的妊娠和孕产妇结局；并根据里约热内卢州（RJ）住院治疗的资金类型评估预防艾滋病毒垂直传播的过程指标。
2021年至2023年期间对1923名妇女进行了横断面研究。对妇女进行了访谈，并从妊娠手册和医院记录中提取数据。根据分娩或流产住院治疗的资金类型——公共或私人，估计艾滋病毒感染的流行率、妊娠和孕产妇结局以及艾滋病毒感染管理过程指标的充分性，并分别给出95%置信区间（95%CI）。
产前护理（PNC）覆盖率、PNC期间的艾滋病毒检测（一次和两次检测）以及住院期间的检测率分别为93.7%、79.7%、45.8%和79.2%。艾滋病毒感染的流行率估计为0.79%（95%CI 0.31 - 1.99）。只有40%的感染艾滋病毒的妇女在其妊娠手册中登记了抗逆转录病毒治疗，26%的妇女登记了病毒载量检测。获得公共资金的妇女社会脆弱性更高，PNC覆盖率和两次检测的覆盖率更低。
在RJ的公共和私人服务中，艾滋病毒感染孕妇的管理中存在错失的机会。检测率高于法定传染病信息系统，表明存在病例报告不足的情况。
