Voluntary HIV counseling and testing during prenatal care in Brazil

Abstract

ObjectiveVoluntary HIV counseling and testing are provided to all Brazilian pregnant women with the purpose of reducing mother-to-child HIV transmission. The purpose of the study was to assess characteristics of HIV testing and identify factors associated with HIV counseling and testing. Methods A cross-sectional study was carried out comprising 1,658 mothers living in Porto Alegre, Brazil. Biological, reproductive and social variables were obtained from mothers by means of a standardized questionnaire. Being counseling about HIV testing was the dependent variable. Confidence intervals, chi-square test and hierarchical logistic model were used to determine the association between counseling and maternal variables. ResultsOf 1,658 mothers interviewed, 1,603 or 96.7% (95% CI: 95.7-97.5) underwent HIV testing, and 51 or 3.1% (95% CI: 2.3-4.0) were not tested. Four (0.2%) refused to undergo testing after counseling. Of 51 women not tested in this study, 30 had undergone the testing previously. Of 1,603 women tested, 630 or 39.3% (95% CI: 36.9-41.7) received counseling, 947 or 59.2% (95% CI: 56.6-61.5) did not, and 26 (1.6%) did not inform. Low income, lack of prenatal care, late beginning of prenatal care, use of rapid testing, and receiving prenatal in the public sector were variables independently associated with a lower probability of getting counseling about HIV testing. ConclusionsThe study findings confirmed the high rate of prenatal HIV testing in Porto Alegre. However, women coming from less privileged social groups were less likely to receive information and benefit from counseling. Resumo Objetivo5 3 5 5 3 5 5 3 5 5 3 5 5 3 Rev Saúde Pública 2003

Percepção de pacientes com AIDS diagnosticada na adolescência sobre o aconselhamento pré e pós-teste HIV realizado

“…In the post-test upon diagnosis, counseling had been recognized by 20 (51.2%) interlocutors. A small percentage of patients who reported having received counseling was also observed in cross-sectional survey conducted by Goldani et al 7 in Porto Alegre -RS, with 1603 women tested during pregnancy, from which only 39.2% reported having been counselled about the test. The authors found that there was a greater chance of not receiving counseling among low-income pregnant women and who initiated prenatal tests belatedly.…”

Avaliação das ações de controle da sífilis e do HIV na assistência pré-natal da rede pública do município do Rio de Janeiro, Brasil

“…Este resultado é inferior ao encontrado por Veloso et al 18 em inquérito nacional realizado com puérperas, em que cerca de 14% referiam ter sido testadas sem seu conhecimento ou autorização, mas semelhante ao verificado em estudos na Região Sul do país. 22,23 Problemas no aconselhamento também têm sido identificados no momento da admissão para o parto. 24 Em relação à sífilis, embora os instrumentos adotados não contivessem dados sobre o aconselhamento pré e pós-teste, a falta de informação sobre a solicitação e/ou realização do exame e o desconhecimento de resultados de exames positivos revelam também problemas nessa abordagem.…”

Aconselhamento sobre o teste rápido anti-HIV em parturientes

“…In this way, they tend to provide more information during hospital procedures, including the time when the HIV rapid test is performed in this population. In contrast, a study on anti-HIV tests performed prior to delivery, conducted in the city of Porto Alegre, showed that the absence of prenatal care, the use of the HIV rapid test, multiparity and low income increased the chance of non-counseling 17 . Low-income women were expected to receive more care and, consequently, more counseling from the health team.…”