Program for Prevention of Mother-to-Child Transmission of Syphilis and HIV in Brazil

Abstract

While antenatal screening for HIV and syphilis is part of the national policy in Brazil, screening and treatment coverage remain inadequate in many parts of the country. This study aimed to describe missed opportunities concerning mother-to-child transmission (MTCT) from the point-of-view of pregnant women, health professionals, and health care managers. A semi-structured interview was conducted in six Brazilian states. Pregnant women, health professionals, and health care managers were interviewed to identify failures in the process of care for pregnant women and MTCT of syphilis or HIV. The project had a quantitative approach but included open-ended questions to capture the views of participants regarding the feasibility of strategies adopted for controlling MTCT. The sample consisted of 109 women, 62 health professionals, and 34 health care managers. The median age of women was 24 (range: 15–46) years, and the median schooling was 8 years. Eighty percent of those interviewed received prenatal care. Among those who attended antenatal visits, the median was 6.43 (range: 1–20) visits. Managers and health professionals had a median of 10 (range: 4–25) working years. In the interviews, the managers declared that they had provided tests and treatment for these infections, but health professionals stated that they did not have tests or treatment available to offer, and most women complained about the difficulties of receiving treatment. Organizing the logistics and breaking down barriers related to care in Brazil is challenging. An adequate health care system and policy factors that address this situation can help to eliminate MTCT by implementing strategies adopted to control these infections in the country.

Keywords

• Mother-to-child transmission
• HIV
• syphilis
• health system
• health policy