Disparities in mother-to-child transmission in Northeast Brazil: regional failures within
successful country programs
L. Kerr1, M.D.S. Cavalcante1, M. Galvão2, I. Dourado3, M. Machado1, C. Kendall4
1Universidade Federal do Ceará, Saúde Comunitária, Fortaleza, Brazil, 2Universidade Federal do Ceará, Departamento de Enfermagem, Fortaleza, Brazil, 3Universidade Federal da Bahia, Instituto de Saúde Coletiva, Salvador, Brazil, 4Tulane University School of Public Health and Tropical Medicine, Center for Global Health Equity, New Orleans, United States
HIV prevention has been successful in developing countries but the disparities
in the success between rich countries and poor countries have also been
observed. Access to PMTCT remains a
challenge in many developing countries.
In 2007, the Ministry of Health launched the Plan to Reduce the Vertical
Transmission of HIV and Syphilis in Brazil to address this need.
cross-sectional study of children infected by HIV and/or living with parents
with HIV/AIDS and/or who died of AIDS in Ceará State, Northeast Brazil was conducted
between June 2008 and January 2009 to explore socioeconomic effects of HIV
of children with an HIV positive test was calculated and stratified by age to
estimate the impact of PMTCT programs. Chi-square test was employed to compare
those proportions. Stata?10.0 software was used for the calculation.
Results: We interviewed
466 adults in hospital waiting for either a personal consultation for HIV, or
who were responsible for children less than 13 years old with HIV. They also
provided information about their family (n=1789). Our
study showed that the children that are infected with HIV and/or who live in a
household with one or both parents infected with HIV or dead from AIDS live in
families of low social class and educational achievement. Seroprevalence
does not demonstrate a reduction between the 0-2 cohort as compared to 3-4 and
5-12 years of age.
Conclusions: Brazil, with its successful PMTCT program
overall, demonstrates great disparities.
Data reported from this area are equivalent to many poor areas in
sub-Saharan Africa. This argues that the global concerns for areas most
affected by the epidemic must consider areas within some of the most prosperous
countries in the world as targets.
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