title: [Evaluation of the cascade of care in prevention of mother-to-child HIV transmission in Brazil].
abstract: This study aimed to assess the cascade of care in the reduction of mother-to-child HIV transmission in the states of Amazonas, Ceará, Espírito Santo, Rio de Janeiro, and Rio Grande do Sul and the Distrito Federal, Brazil, using data from the Brazilian Information System on Diseases of Notification (SINAN). From 2007 to 2012, there was an increase (from 7.3% in Distrito Federal to 46.1% in Amazonas) in intra-gestational detection of HIV in 5 states, with a 18.6% reduction in Rio de Janeiro. Fewer than 90% of the women received antiretroviral therapy during their prenatal care, including those that already knew they were HIV-positive. The elective cesarean rate was low. The AIDS detection rate in children under 5 years as a proxy for mother-to-child HIV transmission showed a reduction of 6.3% from 2007 to 2012, and was highest in Rio Grande do Sul (50%), the state with the highest rates in the period, while Espírito Santo showed the highest increase (50%). Evaluation of the cascade of HIV care in pregnant women identified flaws in all the points. A link is needed between primary care and referral centers for HIV/AIDS, organizing care for the family and better outcomes for the children.
authors.affiliation: Universidade Federal do Espírito Santo, Vitória, Brasil.
authors.forename: Angelica Espinosa
authors.initials: AE
authors.lastname: Miranda
authors.affiliation: Departamento Nacional de DST, AIDS e Hepatites Virais, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Brasil.
authors.forename: Gerson Fernando Mendes
authors.initials: GF
authors.lastname: Pereira
authors.affiliation: Programa de Pós-graduação em Saúde Coletiva, Universidade de Fortaleza, Fortaleza, Brasil.
authors.forename: Maria Alix Leite
authors.initials: MA
authors.lastname: Araujo
authors.affiliation: Departamento Materno-Infantil, Universidade Federal de Pelotas, Pelotas, Brasil.
authors.forename: Mariangela Freitas da
authors.initials: MF
authors.lastname: Silveira
authors.affiliation: Secretaria de Saúde do Distrito Federal, Brasília, Brasil.
authors.forename: Leonor De Lannoy
authors.initials: Lde L
authors.lastname: Tavares
authors.affiliation: Fundação de Vigilância em Saúde, Secretaria de Estado de Saúde do Amazonas, Manus, Brasil.
authors.forename: Leila Cristina Ferreira da
authors.initials: LC
authors.lastname: Silva
authors.affiliation: Programa Estadual de DST/AIDS, Secretaria de Estado da Saúde do Espírito Santo, Vitória, Brasil.
authors.forename: Sandra Fagundes
authors.initials: SF
authors.lastname: Moreira-Silva
authors.affiliation: Secretaria Municipal de Saúde do Rio de Janeiro, Rio de Janeiro, Brasil.
authors.forename: Valéria
authors.initials: V
authors.lastname: Saraceni
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001938:Brazil; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control / Q000635:transmission*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control* / Q000706:statistics & numerical data*; D007256:Information Systems; D009035:Mothers; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000517:prevention & control*; D011295:Prenatal Care; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents