Prevalence of and risk factors for late diagnosis of HIV infection in Brazilian infants and children

Lemos, Lígia Mara Dolce de; Anglemyer, Andrew; Santos, Victor Santana; Gurgel, Ricardo Queiróz; Rutherford, George W

doi:10.1590/0037-8682-0257-2014

Cited by 6 publications

(5 citation statements)

References 7 publications

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“…The absence of this information suggests flaws in the follow-up care routines of newborns exposed to HIV. Local studies have reported late diagnosis of HIV in children [ 29 ] and follow-up losses that can reach 30% in some places in the country [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Mother to child transmission of HIV in Brazil: Data from the "Birth in Brazil study", a national hospital-based study

2018

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Aimsto estimate the mother to child transmission (MTCT) of HIV among infected pregnant women identified in the "Birth in Brazil" study and to evaluate care practices provided in order to identify missed opportunities at preventing the MTCT of HIV infection in the country.MethodsDescriptive study using data obtained from the consultation of different databases: the “Birth in Brazil” study database and the Brazilian National Information Systems (NIS) databases. We used cases of pregnant women infected with HIV identified in the “Birth in Brazil” study, and cases of AIDS in children under 5 years old identified in the NIS, to estimate the MTCT of HIV infection in the country, with a 95% confidence interval. We also estimated the HIV cascade (HIV diagnosis; use of antiretroviral treatment (ART) during pregnancy, labour, and for the newborn; adequate care during childbirth considering viral load at birth; and no breastfeeding) using data from the same sources.ResultsMTCT of HIV of 2.0% (95% CI 0.3%-13.8%). At birth, 84.0% of HIV infected woman showed a positive HIV diagnosis, 74.9% received combined ART during pregnancy, 80.7% received ART during childbirth, 77.1% received adequate care during childbirth, 86.8% of newborns received ART within the first 24 hours after birth, and 2.8% of newborns were breastfed. Considering all steps, 61.3% of the women (95% CI 48.3%-72.8%) received all available medical interventions. In the analysis restricted to women identified in the NIS, 65.3% (95% CI 48.0%-79.3%) of HIV infected women received all available medical interventions.ConclusionBrazil has healthcare policies that guarantee free access to tests, ART and substitutes for maternal milk. However, missed opportunities to prevent MTCT of HIV were identified in at least one-third of women and may be making it difficult to reach HIV-elimination targets especially in the less developed country regions.

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Section: Discussionmentioning

confidence: 99%

Mother to child transmission of HIV in Brazil: Data from the "Birth in Brazil study", a national hospital-based study

2018

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“…This bad news is communicated between adults at a time when the child is already sick and has been hospitalized for a while. This means that antiretroviral treatment starts with a delay, contributing to increased morbidity and mortality (Johnson et al., ; Lemos, Anglemyer, Santos, Gurgel, & Rutherford, ; Wamalwa et al., ).…”

Section: Discussionmentioning

confidence: 99%

“…In a study by Lemos et al. (), the value of family participation in caring for the person with HIV/aids was identified, as the family considers him/her as the centre of care. In this study, family members cited the importance of nurses, psychologists and physicians in nonsystematic consultations about the disclosure of HIV to the children.…”

Section: Discussionmentioning

confidence: 99%

Advocacy care on HIV disclosure to children

Bubadué

Cabral

2018

Nursing Inquiry

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Children with HIV are dependent on taking continuous medication and care, and family preparation is required when disclosing HIV. This study aimed to unveil families’ experiences with HIV disclosure to children under 13 years old. Eight family members who have disclosed HIV to seropositive children were interviewed in‐depth and individually. The fieldwork took place at a public paediatric outpatient hospital in Rio de Janeiro. The results showed that the family members’ discourse highlighted two ways of knowing their own condition and disclosing the condition of the children with HIV. First, they needed to address the communication of bad news and discover their own HIV status through their children's disease. Second, the disclosure was a process constituted by four stages: preparing for disclosure, identifying the time, deciding how and where to tell, and instilling silence after disclosure. They also recognized that nurses had a role in the process as part of an interprofessional team. Nurses can develop advocacy care and empower family members in the preparation of safe HIV disclosure. By systematizing and institutionalizing the care advocacy process, nurses may enable caretakers and children to participate in their therapeutic management, improving adherence to the treatment and self‐care with autonomy.

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“…1 These delays result in missed opportunities for timely antiretroviral therapy (ART) initiation and are a significant cause of HIV-related pediatric morbidity and mortality. 5 , 6 Indeed, late provision of HIV care and treatment undermines the benefits of ART and compromises survival. 7 Globally, 46% of the world's 1.7 million children living with HIV (CLHIV) were not on lifesaving treatment in 2020.…”

Section: Introductionmentioning

confidence: 99%

“Testing Can Be Done Anywhere”: A Qualitative Assessment of Targeted Community-Based Point-of-Care Early Infant Diagnosis of HIV in Lusaka, Zambia

Tembo

Dale²,

Muttau

et al. 2022

Glob Health Sci Pract

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Prevalence of and risk factors for late diagnosis of HIV infection in Brazilian infants and children

Cited by 6 publications

References 7 publications

Mother to child transmission of HIV in Brazil: Data from the "Birth in Brazil study", a national hospital-based study

Mother to child transmission of HIV in Brazil: Data from the "Birth in Brazil study", a national hospital-based study

Advocacy care on HIV disclosure to children

“Testing Can Be Done Anywhere”: A Qualitative Assessment of Targeted Community-Based Point-of-Care Early Infant Diagnosis of HIV in Lusaka, Zambia

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