Surveillance of mother-to-child HIV transmission: socioeconomic and health care coverage indicators

• Published in: Revista de saúde pública Vol. 43; no. 6; pp. 1006 - 1014
• Main Authors: Barcellos, Christovam, Acosta, Lisiane Morelia Weide, Lisboa, Eugenio, Bastos, Francisco Inácio
• Format: Journal Article
• Language: English
• Published: Brazil Faculdade de Saúde Pública da Universidade de São Paulo 01.12.2009
• Subjects: Brazil - epidemiology; Cluster Analysis; Female; Geographic Information Systems; Health Policy & Services; Health Services Accessibility - statistics & numerical data; Health Status Indicators; HIV Infections - epidemiology; HIV Infections - transmission; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical - prevention & control; Infectious Disease Transmission, Vertical - statistics & numerical data; Live Birth - epidemiology; Poverty - statistics & numerical data; Pregnancy; Prenatal Care - statistics & numerical data; Primary Health Care - standards; Sentinel Surveillance; Socioeconomic Factors; Statistics, Nonparametric; Brazil; HIV Infections; Atenção básica de saúde; Acesso aos Serviços de Saúde; Basic Health services; Infectious Disease Transmission, Vertical; Ecological Studies; Socioeconomic Factors; Transmissão Vertical de Doença Infecciosa; Health Inequalities; Health Services Accessibility; Fatores Socioeconômicos; Epidemiologic Surveillance Services; Serviços de Vigilância Epidemiológica; Estudos Ecológicos; Geoprocessamento; Infecções por HIV; Desigualdades em Saúde; Geographic information systems
• ISSN: 0034-8910; 1518-8787; 1518-8787; 0034-8910
• DOI: 10.1590/s0034-89102009005000070

To identify clustering areas of infants exposed to HIV during pregnancy and their association with indicators of primary care coverage and socioeconomic condition. Ecological study where the unit of analysis was primary care coverage areas in the city of Porto Alegre, Southern Brazil, in 2003. Geographical Information System and spatial analysis tools were used to describe indicators of primary care coverage areas and socioeconomic condition, and estimate the prevalence of liveborn infants exposed to HIV during pregnancy and delivery. Data was obtained from Brazilian national databases. The association between different indicators was assessed using Spearman's nonparametric test. There was found an association between HIV infection and high birth rates (r=0.22, p<0.01) and lack of prenatal care (r=0.15, p<0.05). The highest HIV infection rates were seen in areas with poor socioeconomic conditions and difficult access to health services (r=0.28, p<0.01). The association found between higher rate of prenatal care among HIV-infected women and adequate immunization coverage (r=0.35, p<0.01) indicates that early detection of HIV infection is effective in those areas with better primary care services. Urban poverty is a strong determinant of mother-to-child HIV transmission but this trend can be fought with health surveillance at the primary care level.