A trajetória dos casos de transmissão vertical do HIV na região noroeste do Paraná : identificando os nós críticos da assistência

Abstract

Epidemiological, scientific and social changes occurred since the beginning of AIDS epidemic until 2007. The growing number of AIDS in women resulted in vertical transmission (TV) and human immunodeficiency virus where infected mothers transmit the illness to their babies during the pregnancy, childbirth or breastfeeding. The programmatic actions established by the Ministério da Saúde done by the health service in order to prevent these illnesses can reduce the number of infected children occurrence or it can have almost nonexistent chance of occurrence. From the 145 HIV cases that presented TV, where 28 (19,3%) infected children are registered by the Attendance Specialized Service (SAE) from Maringá, used as reference for 30 municipality located in the northeast Paraná region. We tried to analyze the infected women profile, identify the municipality with the highest rates in TV and also check possible mistakes made by the Program de DST/AIDS during the prevention and control of seven infected children. Among these 28 cases of vertical transmission it was observed a low HIV testing coverage during the pregnancy, a late onset or a nonexistence of the TARV introduction in infected mothers, no elective cesareans guarantee and mothers breast feeding compliance. The socioepidemiological characteristics that present TV occurrence showed these profiles: women between 29 and 30 (64,1%), 4 years of study (49,0%), women with no employment connection and a marriage characterized by the presence of the husband (59,3%), only one pregnancy (70,3%), sexual rote contamination (90,3%), and a follow-p with TARV (55,2%). However, the highest rate of TV occurred in young women (64, 1%), women with 12 or more years of study (40,0%) and women with no employment connection (25,3%). Among the TV cases, we can say that there are more mistakes than correct things, all women had prenatal care, 5 women had more than six appointments and six women got the routine exams. However, two women didn't take the HIV test and five of them were not advised to do so. The TARV was introduced after the twentieth week of pregnancy in five women and only one woman took all the medicine. Packages with necessary things were handed to women and they didn't breastfeed. Only two women had appropriate birth according to their illness and AZT infusion. The study permitted us to conclude that the control and prevention measures reduce the TV (HIV) and protect children from this disease. However, the measures preventions were not totally taken. Strategies that promote professional adherence must be conducted as fundamental and evaluations with the professional that work with the infected people assistance should be taken in order to have less infected children, solutions to solve these problems and an ethical agreement practice.