title: Surveillance of mother-to-child HIV transmission: socioeconomic and health care coverage indicators.
abstract: OBJECTIVE
  To identify clustering areas of infants exposed to HIV during pregnancy and their association with indicators of primary care coverage and socioeconomic condition.
  
  
  METHODS
  Ecological study where the unit of analysis was primary care coverage areas in the city of Porto Alegre, Southern Brazil, in 2003. Geographical Information System and spatial analysis tools were used to describe indicators of primary care coverage areas and socioeconomic condition, and estimate the prevalence of liveborn infants exposed to HIV during pregnancy and delivery. Data was obtained from Brazilian national databases. The association between different indicators was assessed using Spearman's nonparametric test.
  
  
  RESULTS
  There was found an association between HIV infection and high birth rates (r=0.22, p<0.01) and lack of prenatal care (r=0.15, p<0.05). The highest HIV infection rates were seen in areas with poor socioeconomic conditions and difficult access to health services (r=0.28, p<0.01). The association found between higher rate of prenatal care among HIV-infected women and adequate immunization coverage (r=0.35, p<0.01) indicates that early detection of HIV infection is effective in those areas with better primary care services.
  
  
  CONCLUSIONS
  Urban poverty is a strong determinant of mother-to-child HIV transmission but this trend can be fought with health surveillance at the primary care level.
authors: Laboratório de Informações em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Avenida Brasil 4365-Manguinhos, Rio de Janeiro, RJ, Brazil. xris@fi ocruz.br
authors: Christovam
authors: C
authors: Barcellos
authors: Lisiane Morelia Weide
authors: LM
authors: Acosta
authors: Eugenio
authors: E
authors: Lisboa
authors: Francisco Inácio
authors: FI
authors: Bastos
mesh_terms: D001938:Brazil / Q000453:epidemiology; D016000:Cluster Analysis; D005260:Female; D040362:Geographic Information Systems; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006305:Health Status Indicators; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control / Q000706:statistics & numerical data*; D050498:Live Birth / Q000453:epidemiology; D011203:Poverty / Q000706:statistics & numerical data; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000592:standards*; D018571:Sentinel Surveillance; D012959:Socioeconomic Factors; D018709:Statistics, Nonparametric