Factors associated with submission to HIV rapid test in childbirth care

Oliveira, Maria Inês Couto de; Silva, Katia Silveira da; Gomes, Daniela Marcondes

doi:10.1590/1413-81232018232.11612016

Acessibilidade / Reportar erro

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Free Themes • Ciênc. saúde colet. 23 (2) • Feb 2018 • https://doi.org/10.1590/1413-81232018232.11612016 copy

Factors associated with submission to HIV rapid test in childbirth care

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Rapid HIV tests are used in maternity hospitals to prevent mother-to-child transmission. This study aimed to analyze factors associated with submission to the rapid HIV test (outcome). This is a cross-sectional study conducted in 2009 in 15 hospitals from the Rio de Janeiro's Unified Health System (SUS) by interviewing a representative sample of 835 pregnant women hospitalized for birth and by verifying medical records. Adjusted prevalence ratios were obtained by Poisson regression according to a hierarchical model, and variables associated with the outcome (p ≤ 0.05) remained in the final model. According to medical records (MR), 79.6% of mothers were submitted to rapid HIV test and, according to interviews (INT), 55.7%. At the distal level, the lack of a partner (MR), having ≥ 6 residents at home (MR) and non-white skin color (INT) were associated with a higher prevalence of the outcome. At the intermediate level, not having a negative HIV serology from prenatal care (MR and INT) was associated with a higher prevalence of the outcome, as well as PHC prenatal care (MR) and lack of prenatal care (INT). At the proximal level, delivery in a hospital not certified as Baby-Friendly was associated with a higher prevalence of outcome (MR and INT).

Key words
Program evaluation and health projects; HIV; AIDS serological diagnosis; Cross-sectional studies; Unified Health System

Distal characteristics		Information from interviews					Information from medical records
Distal characteristics		N	%	Prevalence (%)	Crude PR	p-value	Prevalence (%)	Crude PR	p-value
Age
	20 to 46 years	618	74	56.8	1		78.5	1
	13 to 19 years	217	26	52.5	0.93	0.288	82.9	1.06	0.137
Self-reported skin color
	White	219	26.2	50.2	1		83.1	1
	Non-white	616	73.8	57.6	1.15	0.069	78.4	0.94	0.117
Schooling
	≥ Elementary school completed	555	66.5	57.5	1		79.3	1
	Incomplete elementary school	280	33.5	52.1	0.91	0.151	80.4	1.01	0.713
Paid work
	Yes	422	50.5	56.6	1		78.7	1
	No	413	49.5	54.7	0.97	0.578	80.6	1.03	0.483
Mother's income
	≥ 1 minimum wage	278	33.3	57.6	1		79.1	1
	< 1 minimum wage	555	66.7	55.0	0.96	0.472	79.8	1.01	0.819
Partner
	With partner	723	86.6	56.0	1		78.1	1
	Without partner	112	13.4	53.6	0.96	0.635	89.3	1.14	<0.001
Parity
	Primiparous	399	47.8	52.1	1		79.8	1
	Non-primiparous	436	52.2	58.9	1.13	0.049	79.4	0.99	0.895
Number of residents
	Up to 5	625	74.9	54.6	1		77.8	1
	6 or over	210	25.1	59.0	1.08	0.246	85.2	1.10	0.010

Intermediate characteristics		Information from interviews					Information from medical records
Intermediate characteristics		N	%	Prevalence (%)	Crude PR	p-value	Prevalence (%)	Crude PR	p-value
Performance of prenatal care (PN)
	Yes	796	95.3	54.1	1		78.6	1
	No	39	4.7	87.2	1.61	<0.001	100	1,27	<0,001
Type of PN care service
	PHC facility	523	65.7	53.7	1		84.9
	Hospital services	273	34.3	54.9	1.02	0.743	66.7	0,79	<0,001
PN initiation
	1st trimester	531	63.6	52.2	1		77.2	1
	2nd or 3rd trimester or no PN	304	36.4	61.8	1.19	0.005	83.9	1,09	0,016
Number of PN consultations
	6 or over consultations	589	70.6	52.6	1		77.4	1
	0 to 5 consultations	245	29.4	62.9	1.19	0.005	84.9	1,10	0,008
Performing HIV test in PN
	Yes	764	91.5	53.9	1		78.4	1
	No or doesn't know or no PN	71	8.5	74.6	1.38	<0.001	93.0	1,19	<0,001
HIV serology in PN^* * Source of Information: mother's interview.
	Negative serology of 1 or more exams	724	86.7	53.3	1		-	-	-
	No negative serology available	111	13.3	71.2	1.34	<0.001
HIV serology in PN^ Source of information: medical records.
	Negative serology of 1 or more exams	568	68.0	-	-	-	71.1	1
	No negative serology available	267	32.0				97.8	1,37	<0,001
	Proximal characteristics
Delivery type
	Normal	530	63.5	57.5	1		82.2	1
	Cesarean	305	36.5	52.5	0.90	0.157	75.1	0,91	0,019
Birth at Baby-Friendly Hospital
	Yes	424	50.8	48.6	1		77.1	1
	No	411	49.2	63.0	1.30	<0.001	82.2	1,07	0,067

Distal characteristics		Adjusted PR	CI 95%	p-value
Self-reported skin color
	White	1
	Non-white	1.16	1.00-1.33	0.049
Schooling
	≥ Elementary school completed	1
	Incomplete elementary school	0.86	0.75-0.98	0.022
Intermediate characteristics
Performance of prenatal care (PN)
	Yes	1
	No	1.29	1.05-1.59	0.018
Interview data on the HIV serology of PN
	Negative serology of 1 or more exams	1
	No negative serology available	1.23	1.02-1.47	0.031
Proximal characteristics
Birth at Baby-Friendly Hospital
	Yes	1
	No	1.29	1.14-1.45	<0.001

Distal characteristics		Adjusted PR	IC 95%	p-value
Partner
	With partner	1
	Without partner	1.13	1.04-1.22	0.002
Number of residents
	Up to 5	1
	6 or over	1.08	1.01-1.16	0.031
Intermediate characteristics
Type of PN care service
	PHC facility	1
	Hospital services	0.81	0.74-0.88	<0.001
Medical records data on HIV serology of PN
	Negative serology of 1 or more exams	1
	No negative serology available	1.34	1.26-1.41	<0.001
Proximal characteristics
Birth at Baby-Friendly Hospital
	Yes	1
	No	1.08	1.00-1.16	0.040

ABRASCO - Associação Brasileira de Saúde Coletiva Av. Brasil, 4036 - sala 700 Manguinhos, 21040-361 Rio de Janeiro RJ - Brazil, Tel.: +55 21 3882-9153 / 3882-9151 - Rio de Janeiro - RJ - Brazil
E-mail: cienciasaudecoletiva@fiocruz.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Collaborations

MIC Oliveira was the main responsible for the outline and design of the study, for data analysis and interpretation and paper writing. DM Gomes was responsible for reviewing literature on the subject and participated in data analysis and interpretation, as well as paper writing. KS Silva participated in data analysis and interpretation and paper critical review.