Missed opportunities for congenital syphilis and HIV perinatal transmission prevention

Revista de Saúde Pública

Celeste Souza Rodrigues²  Mark Drew Crosland Guimarães¹  Cibele Comini César¹ 

[1] ,Secretaria Municipal de Saúde de Belo Horizonte Gerência de Vigilância em Saúde e Informação Belo Horizonte MG ,Brasil

关键词: Syphilis;    Congenital;    HIV Infections;    Disease Transmission;    Vertical;    Prenatal Care;    Cross-Sectional Studies;    Missed Prevention Opportunity;    Sífilis Congênita;    Infecções por HIV;    Transmissão Vertical de Doença;    Cuidado Pré-Natal;    Estudos Transversais;    Oportunidade Perdida de Prevenção;    Sífilis Congénita;    Infecciones por HIV;    Transmisión Vertical de Enfermedad;    Atención Prenatal;    Estudios Transversales;    Oportunidad Pérdida de Prevención;   

DOI  :  10.1590/S0034-89102008000500010

来源: SciELO

【 摘 要 】

OBJECTIVE: To estimate the prevalence of missed opportunities for congenital syphilis and HIV prevention in pregnant women who had access to prenatal care and to assess factors associated to non-testing of these infections. METHODS: Cross-sectional study comprising a randomly selected sample of 2,145 puerperal women who were admitted in maternity hospitals for delivery or curettage and had attended at least one prenatal care visit, in Brazil between 1999 and 2000. No syphilis and/or anti-HIV testing during pregnancy was a marker for missed prevention opportunity. Women who were not tested for either or both were compared to those who had at least one syphilis and one anti-HIV testing performed during pregnancy (reference category). The prevalence of missed prevention opportunity was estimated for each category with 95% confidence intervals. Factors independently associated with missed prevention opportunity were assessed through multinomial logistic regression. RESULTS: The prevalence of missed prevention opportunity for syphilis or anti-HIV was 41.2% and 56.0%, respectively. The multivariate analysis showed that race/skin color (non-white), schooling (<8 years), marital status (single), income (<3 monthly minimum wages), having sex during pregnancy, history of syphilis prior to the current pregnancy, number of prenatal care visits (<6), and last prenatal visit before the third trimester of gestation were associated with an increased risk of missed prevention opportunity. A negative association with missed prevention opportunity was found between marital status (single), prenatal care site (hospital) and first prenatal visit in the third trimester of gestation. CONCLUSIONS: High rates of non-tested women indicate failures in preventive and control actions for HIV infection and congenital syphilis. Pregnant women have been discontinuing prenatal care at an early stage and are failing to undergo prenatal screening for HIV and syphilis.

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