Gestantes HIV+/AIDS no Brasil: 15 anos de uma epidemia desigual

Abstract

The epidemiological profile of HIV / AIDS infection in Brazil has undergone changes in recent years, the phenomenon known as feminization of the epidemic, characterized by the increase in the number of cases in women of childbearing age and consequent increase in the risk of vertical transmission. The study describes the epidemiological profile of HIV + / AIDS pregnant women in Rio Grande do Norte (RN) and Brazil and analyzes the quality of the data available in the National Information System for Notification Diseases (SINAN). The quality of the available data was evaluated according to the completeness of the records, being classified as excellent, fair and poor. In the state of the RN, it also evaluated the presence of dissonance in the notification of pregnant women and HIV + / AIDS women between the services of Epidemiological Surveillance of the RN and the data available in SINAN / DATASUS. In addition, it analyzed the behavior of the historical series of HIV + / AIDS pregnant women, from 2000 to 2013, in Brazil, regions and federative units, according to race / color, prenatal, age and schooling. For the analysis of the tendency of the coefficient of HIV + / AIDS pregnant women, the polynomial regression method was used. We selected contextual factors related to the epidemic and after multiple linear regression, we selected those capable of explaining the percentage of variation of the coefficient of HIV + / AIDS pregnant women. In the state of the RN, between 2007 and 2014, the data showed a completeness considered excellent in the socio-demographic variables. As for the variables related to prenatal care and delivery, it ranged from poor to regular. Dissonance was identified in the notification of pregnant women and HIV + / AIDS women between the services of Epidemiological Surveillance of the NB and the data available in SINAN / DATASUS. HIV + / HIV pregnant women were characterized by being in the reproductive age group, black, schooling less than eight years old and living in the urban area. In Brazil, from 2000 to 2014, most socio-demographic variables obtained excellent completeness, being regular for most variables related to prenatal and childbirth. It was also observed that the epidemic has a heterogeneous behavior, following a growing tendency in most states. In relation to the race / color, prenatal, age and schooling variables, it can be observed that adolescents who did not have prenatal, black and illiterate had a greater average annual increase in the coefficient of HIV / AIDS infection. Among the contextual factors, the higher the number of men infected with HIV, the greater the percentage of variation in the infection coefficient of HIV + / AIDS pregnant women. The increase in the HDI and the White / Black Rate corresponded to a decrease in the percentage of variation in the infection coefficient of HIV + / AIDS pregnant women. It is concluded that information systems, although they allow a knowledge about HIV + / AIDS pregnant women, it is necessary to optimize the notification of cases, increase the completeness and consequently the quality of the information produced, be it at the national, state or municipal level, reducing the dissonance Between the data produced at these three levels. The epidemiological profile of HIV / AIDS pregnant women reflects the social vulnerability of these women, reflected in the increase observed throughout the historical series and in contextual factors correlated to it.