Why does not the MTCT of HIV rate go down in Buenos Aires City?
F.E. Portnoy1, A. Duran2, M. Vila2, M. Nan2, A. Maranzana2, S. Vulcano2, L. Marachlian2, A. Basombrio2
1AIDS Coordination / AIDS Programm, Ministry of Health, Government of the Autonomous City of Buenos Aires (CABA), Buenos Aires, Argentina, 2AIDS Coordination / Ministry of Health, Government of the Autonomous City of Buenos Aires (CABA), Buenos Aires, Argentina
Issues: MTCT in Buenos Aires City has noticeably decreased during last years (20% in 2000; 5.9% in 2008). However, with relatively stable annual rates which go around 6% from 2003 to 2008, we are not reaching the expected results for districts that, like the CABA, have the recommended resources with which the MTCT would be reduced to its minimal expression (from 0 to 2 percent).
Description: We describe such variables which were associated to MTCT in CABA from the analysis made to 1623 advices of childbirths of women with HIV in public system hospitals within the city during the 2003/2008 period. MTCT has been strongly associated with: 1- Whether Prenatal Care (PC) has taken place or not, with rates of 2.9% with PC and of 20.4% without PC;2- the moment of HIV-positive diagnosis, with MTCT rates which go from 3% in HIV-positive women whose diagnosis is previous to pregnancy, to 35% in women whose diagnosis is made during the postnatal period;3- The mother education level, with rates from 22.2% in women with unfinished elementary school, goes down while education level goes up.
Lessons learned: Most sound variables associated with MTCT were the moment of diagnosis and the access to prenatal care. During the six years study period the proportion of women who, for different reasons, did not received prenatal care, has been kept relatively constant (between 15 and 20 percent).
Next steps: To implement strategies which facilitate the timely access to the public health system, particularly, for those women who live outside the city, constitutes a key factor to reduce MTCT figures. We are heading in that direction, along with health authorities of the suburb districts which are close to the CABA.
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