Risk factors for HIV infection among parturients and rate of mother-to-child-transmission in Salvador, Brazil
I. Nobrega, P. Dantas, P. Cordeiro, E. Netto, C. Brites
Federal University of Bahia, Medicine, Salvador, Brazil
Background: Salvador, is the third largest Brazilian city, 80% of its population is black or racially mixed and has a low human development.
Methods: We interviewed 3034 delivering mothers in Salvador, Bahia, between May 2008 and April 2009. All mothers had two different rapid HIV tests performed at admission. Those tested positive for HIV and their babies received standard prophylaxis to MTCT. A blood sample was collected for confirmatory tests. Age, socio-economical characteristics, and risk activities for HIV-1 acquisition were recorded, as well as clinical parameters. Babies born from positive mothers were tested for HIV-1 RNA (b-DNA) after 3 months.
Results: Mean age was 25.6 ±6.7 years. Almost all (93%) were black/racially mixed, and has (79%) a monthly familiar income lower ~US$ 800.00 .Only 4% has university education, 76% were single, and 39% declared only one sexual partner (life time), while 0.1% had a known HIV-positive partner, and 1.6% had a IVDU partner, or referring a previous STD (1.4%). Eight were IVDU. Twenty three (0.8%) tested positive. HIV infection was associated with a HIV-infected sexual partner (OR=333.3, 95% CI: 29.48- 8303.4), or presenting with a previous STD (OR=7.39, IC 95%: 2.33-23.48)as well as previous blood transfusion (OR=12.9, 95% CI: 2.85 - 58.86), or accidental exposure to blood (OR=15.88, 95% CI:4.47 - 57.1), and lower education (< 5 years in school) . Antenatal care (OR=0.29, 95% CI: 0.1 - 0.9, p=0.02) and married status (OR=0.16, 95% CI: 0.01 -0.75, p=0.04) were protective against HIV infection. Number of previous pregnancies/abortions were higher for HIV-positive women (p< 0.05). After 3 months 20/23 babies born from positive mothers were HIV-negative by b-DNA, and 5 were lost to follow up.
Conclusions: prevalence of HIV-1 infection in this population was low, and no MTCT was detected. Low access to education and health services were predictive of HIV infection.
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