TY - JOUR
T1 - Factors associated with prenatal care and HIV and syphilis testing during pregnancy in primary health care
AU - Freitas, Claudia Helena Soares de Morais
AU - Forte, Franklin Delano Soares
AU - Roncalli, Ângelo Giuseppe
AU - Galvão, Maria Helena Rodrigues
AU - Alves Coelho, Ardigleusa
AU - Dias, S
PY - 2019/9/23
Y1 - 2019/9/23
N2 - Objective: To evaluate the factors associated with HIV and syphilis testing during pregnancy in Brazil.
Methods: This was an ecological study covering all Brazilian municipalities evaluated by the second cycle of the National Program for Access and Quality Improvement in Primary Care, 2013-2014. The dependent variables were based on prenatal care access: prenatal care appointments, and HIV and syphilis tests during prenatal care. The independent variables were compared with demographic and social characteristics. Bivariate analysis was performed assessing the three outcomes with the independent variables. Variables with significant associations in this bivariate analysis were fit in a Poisson multiple regression analysis with robust variance to obtain adjusted estimates.
Result: Poisson regression analysis showed a statistically significant association with the variables "less than eight years of study" [prevalence ratio (PR) = 1.31; 95%CI 1.19-1.45; p < 0.001] and "participants of the cash transfer program" (PR = 0.80; 95%CI 0.72-0.88; p < 0.001) for the outcome of "having less than six prenatal care appointments" and individual variables. A statistically significant association was found for "participants of the cash transfer program" (PR = 1.43; 95%CI 1.19-1.72; p < 0.001) regarding the outcome from the comparison between HIV testing absence during prenatal care and demographic and social characteristics. The absence of syphilis testing during prenatal care, and demographic and social characteristics presented a statistically significant association for the education level variable "less than eight years of study" (PR =1.75; 95%CI 1.56-1.96; p < 0.001) and "participants of the cash transfer program" (PR = 1.21, 95%CI 1.07-1.36; p < 0.001).
Conclusions: The individual factors were associated with prenatal care appointments and HIV and syphilis tests in Brazilian pregnant women. They show missed opportunities for diagnosing HIV and syphilis infection during prenatal care and indicate weaknesses in the quality of maternal health care services to eliminate mother-to-child transmission.
AB - Objective: To evaluate the factors associated with HIV and syphilis testing during pregnancy in Brazil.
Methods: This was an ecological study covering all Brazilian municipalities evaluated by the second cycle of the National Program for Access and Quality Improvement in Primary Care, 2013-2014. The dependent variables were based on prenatal care access: prenatal care appointments, and HIV and syphilis tests during prenatal care. The independent variables were compared with demographic and social characteristics. Bivariate analysis was performed assessing the three outcomes with the independent variables. Variables with significant associations in this bivariate analysis were fit in a Poisson multiple regression analysis with robust variance to obtain adjusted estimates.
Result: Poisson regression analysis showed a statistically significant association with the variables "less than eight years of study" [prevalence ratio (PR) = 1.31; 95%CI 1.19-1.45; p < 0.001] and "participants of the cash transfer program" (PR = 0.80; 95%CI 0.72-0.88; p < 0.001) for the outcome of "having less than six prenatal care appointments" and individual variables. A statistically significant association was found for "participants of the cash transfer program" (PR = 1.43; 95%CI 1.19-1.72; p < 0.001) regarding the outcome from the comparison between HIV testing absence during prenatal care and demographic and social characteristics. The absence of syphilis testing during prenatal care, and demographic and social characteristics presented a statistically significant association for the education level variable "less than eight years of study" (PR =1.75; 95%CI 1.56-1.96; p < 0.001) and "participants of the cash transfer program" (PR = 1.21, 95%CI 1.07-1.36; p < 0.001).
Conclusions: The individual factors were associated with prenatal care appointments and HIV and syphilis tests in Brazilian pregnant women. They show missed opportunities for diagnosing HIV and syphilis infection during prenatal care and indicate weaknesses in the quality of maternal health care services to eliminate mother-to-child transmission.
KW - Prenatal Care
KW - HIV infections
KW - Diagnosis
KW - AIDS serodiagnosis
KW - Syphilis
KW - Congenital
KW - Infectious disease transmission
KW - Vertical
KW - Prevention and control
KW - Health care quality
KW - Access
KW - Evaluation
UR - https://pubmed.ncbi.nlm.nih.gov/31553379-factors-associated-with-prenatal-care-and-hiv-and-syphilis-testing-during-pregnancy-in-primary-health-care/?from_term=Factors+associated+with+prenatal+care+and+HIV+and+syphilis+testing+during+pregnancy+in+primary+health+care&from_pos=1
U2 - 10.11606/s1518-8787.2019053001205
DO - 10.11606/s1518-8787.2019053001205
M3 - Article
C2 - 31553379
VL - 53
JO - Revista de Saúde Pública
JF - Revista de Saúde Pública
SN - 0034-8910
M1 - 76
ER -
