Implementing preventive strategies to eliminate mother-to-child transmission of HIV in the State of São Paulo, Brazil
Â. Tayra, M.A. Silva, C.S.B. Domingues, L.H. Matida, M.C. Polon, J.C.O. Dantas, M.H. Silva, M.C. Gianna
State Program of STD/AIDS, São Paulo, Brazil, São Paulo, Brazil
Issues: To evaluate the 15%reduction in the incidence rate of AIDS among children under 5 years of age, in the State of Sao Paulo, according to the 2008 National proposal.
Description: Between 1987 and June 2009, 4,680 AIDS cases of mother-to-child transmission (MTCT) were reported in São Paulo, and 3,675 cases (78.5%) occurred in children under 5 years of age. The incidence rate in this age group decreased nine times (from 11.8 in 1997 to 1.1/100,000 in 2008).
Lessons learned: The reduction of AIDS cases in children under 5 years of age is attributable to the reduction of MTCT of HIV, with the offer of HIV testing to all pregnant women and the control of infected pregnant women and infants born to infected mothers. However, the occurrence of AIDS in children should be considered as a sentinel event of prenatal quality care and of the monitoring of children exposed to vulnerability to STD / AIDS (homeless, drug abuse, people living in prisons and their families, migration, social exclusion and others) that requires intervention measures in accordance with the local scenario and needs.
Next steps: Agreement with the 645 counties in the State of São Paulo:
(i) investigation of all AIDS cases in children,
(ii) identification of missed opportunities for prevention of AIDS cases in children, and
(iii) increased monitoring of children exposed to HIV in specialized centers.
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