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Factors Associated with Maternal-Child Transmission of HIV-1 in Southeastern Brazil: A Retrospective Study

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Abstract

Mother-to-child transmission (MTCT) is the main mode of HIV-1 acquisition among young children worldwide. The goals of this study were to estimate the proportion of HIV MTCT and to identify factors associated with transmission. We reviewed data for HIV-infected pregnant women that had been reported to the National Information on Reportable Diseases System (SINAN) in Espírito Santo state, Brazil, between January 2007 and December 2012. HIV cases in children were followed until age 18 months. The proportion of women who transmitted HIV to their babies was 14% (95% CI 11–17%). In a multivariate logistic regression model, pregnant women who had lower than primary school education (OR 2.74; 95% CI 1.31–5.71), had 2 or more pregnancies during the study period (OR 2.28; 95% CI 1.07–4.84), had emergency cesarean delivery (OR 4.32; 95% CI 1.57–11.9), and did not receive antiretroviral therapy during prenatal care (OR 2.41; 95% CI 1.09–5.31) had higher odds of HIV MTCT. Effort should be made to encourage health care workers and pregnant women to use services for the prevention of MTCT.

Resumen

La transmisión materno-infantil (TMI) es el principal modo de adquisición del VIH-1 entre los niños de todo el mundo. Los objetivos del estudio fueron estimar la tasa de TMI del VIH e identificar los factores asociados. Se realizó una revisión de los datos de mujeres embarazadas infectadas por el VIH notificadas al Sistema Nacional de Información sobre Enfermedades Reportables (SINAN) en el estado de Espírito Santo/Brasil, entre enero de 2007 y diciembre de 2012. Los casos de VIH en niños fueron seguidos hasta 18 meses. La proporción de TMI fue del 14% (IC95%:10,9-17,0). En el modelo de regresión logística multivariable, las mujeres embarazadas que tenían menos que la educación primaria (OR = 2,74; IC del 95%: 1,31-5,71), que tuvieron dos o más embarazos durante el estudio del período (OR = 2,28; 95% IC 1,07-4,84), que tuvieron el parto por cesárea de emergencia (OR = 4,32; IC95%:1,57-11,9) y las mujeres embarazadas que no recibieron tratamiento antirretroviral durante la atención prenatal (OR = 2,41; IC95%:1,09-5,31) tuvieron mayor probabilidad de TMI. Deberían realizarse esfuerzos para alentar a los trabajadores sanitarios ya las mujeres embarazadas a que utilicen los servicios de PTMI.

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Acknowledgements

We wish to acknowledge support from the University of California, San Francisco’s International Traineeships in AIDS Prevention Studies (ITAPS), U.S. NIMH, R25MH064712 and the Starr Foundation Scholarship Fund. In addition, we wish to acknowledge support from the Brazilian Ministry of Health, National Foundation of Health. Grant # Termo de 323/2014.

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Authors and Affiliations

  1. Department of Nursing, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil

    Thiago Nascimento do Prado

  2. Post-Graduate Program in Public Health, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil

    Thiago Nascimento do Prado, Eliana Zandonade & Angélica Espinosa Miranda

  3. Global Health Sciences, University of California, San Francisco, USA

    Deborah Bain Brickley & Nancy K. Hills

  4. Serviço de Infectologia, Hospital Infantil Nossa Senhora da Glória, Vitória, Espírito Santo, Brazil

    Sandra Fagundes Moreira-Silva

  5. Post-Graduate Program in Infectious Diseases, Federal University of Espírito Santo, Av. Marechal Campos, 1468, Vitória, Espírito Santo, Brazil

    Angélica Espinosa Miranda

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  1. Thiago Nascimento do Prado
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  2. Deborah Bain Brickley
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Correspondence to Angélica Espinosa Miranda.

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The authors declare that they do not have conflict of interest.

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All procedures performed involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from individual participants included in the study.

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do Prado, T.N., Brickley, D.B., Hills, N.K. et al. Factors Associated with Maternal-Child Transmission of HIV-1 in Southeastern Brazil: A Retrospective Study. AIDS Behav 22 (Suppl 1), 92–98 (2018). https://doi.org/10.1007/s10461-018-2172-8

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  • DOI: https://doi.org/10.1007/s10461-018-2172-8

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