title: Effectiveness of the prevention of mother-to-child HIV transmission in Bahia, Brazil.
abstract: BACKGROUND
  Antiretroviral therapy and prophylaxis during the antepartum, intrapartum and postpartum periods, cesarean delivery and avoidance of breast milk significantly reduce vertical transmission of HIV.
  
  
  OBJECTIVE
  To evaluate the effectiveness prevention of mother-to-child transmission of HIV and determine the rate of vertical transmission in a public sexually transmitted infection and HIV referral center in Salvador, Bahia, in the period immediately prior to the initiation of universal antiretroviral therapy in pregnant women.
  
  
  METHODS
  Cross-sectional study using data collected from medical records of children born to HIV infected mothers in Bahia from 2005 to 2008 who were referred to the Reference Center for Diagnosis and Research of Sexually Transmitted Diseases and HIV/AIDS for care.
  
  
  RESULTS
  Of 232 HIV-exposed infants, 19 (8.2%) had confirmed HIV infection. One hundred eighty-eight (81%) mothers received antenatal care, 120 (52%) antepartum antiretroviral therapy or prophylaxis, and 168 (72%) intrapartum zidovudine. Two hundred twenty-three (96%) infants received zidovudine. In multivariable models, the combination of intrapartum and postpartum antiretroviral prophylaxis was associated with decreased adjusted odds of mother-to-child transmission.
  
  
  CONCLUSIONS
  Low levels of antenatal screening and access to prevention of mother-to-child transmission were significant limitations in the cascade of prevention of mother-to-child transmission at our center in this period.
authors.affiliation: Specialty Center for Diagnosis, Care and Research, Salvador, BA, Brazil.
authors.forename: Fátima Rejane Lemos
authors.initials: FR
authors.lastname: Patricio
authors.affiliation: Global Health Sciences, University of California, San Francisco, USA. Electronic address: george.rutherford@ucsf.edu.
authors.forename: George Williams
authors.initials: GW
authors.lastname: Rutherford
authors.affiliation: Specialty Center for Diagnosis, Care and Research, Salvador, BA, Brazil.
authors.forename: José Henrique Silva
authors.initials: JH
authors.lastname: Barreto
authors.affiliation: Specialty Center for Diagnosis, Care and Research, Salvador, BA, Brazil.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Rodamilans
authors.affiliation: Division of Infectious Diseases, Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil.
authors.forename: Roberto
authors.initials: R
authors.lastname: Badaró
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D001938:Brazil; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D019380:Anti-HIV Agents
keywords: Brazil; Effectiveness; HIV; Vertical transmission