Lost chances to avoid mother-to-child transmission of HIV; Uruguay 2005-2007
Keywords:
VERTICAL DISEASE TRANSMISSION, VIH, URUGUAYAbstract
Despite Uruguay having a STD/HIV National Program under the Ministry of Health, health care services seemingly approachable, and antiretroviral drugs free for those in the public sub-sector, HIV vertical transmission figures are unacceptably high.
Objective: to analyze the existence of lost opportunities that would have avoided infection.
Method: the study examined the clinical records of infected children born between January 1, 2005 and December 31, 2007.
The following variables were analyzed: time of diagnosis, pregnancy follow-up, medication received, form of childbirth, antiretrovirals during birth and for the newborn, breastfeeding. Likewise, psychological condition of mothers was studied, whenever possible.
Results: during this period, 264 children were born of HIV-infected mothers; 13 were infected (vertical transmission 4.9%).
Out of 13 women, 11 of them had no prenatal follow-up, and thus were not administered antiretrovirals; two of them were not administered AZT during birth in spite of diagnosis made through a quick test upon delivery; and four newborns were not administered AZT and were breastfed.
Mothers were under vulnerable social, economic and cultural conditions, since many of them were on their own, took drugs, had psychological problems and evidenced little education. Six of them worked in prostitution.
Two of them died during the child’s first year of life. Two of the fathers were in prison and one of them died in jail.
Conclusions: policies that appeal to pregnant women in the lower economic sectors need to be drafted. The quick test must be carried out systematically in pregnancies with poor prenatal follow-up. Health professionals must be more committed to this condition, almost completely avoidable for children.
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