OBJECTIVES: to assess the health care provided to HIV+pregnant women and their children and determine vertical transmission rates in four Brazilian capitals. METHODS: a cohort study was performed in a population of 1475 HIV+pregnant women and their children, who received health care between 1996 and 2003, in 17 public maternities. Data were collected retrospectively from clinical records and 274 women were interviewed (prospective phase) based on a structured questionnaire. RESULTS: regarding quality of health care, it was verified in the retrospective and prospective phases of the study, respectively, that 24% and 27% of women did not even receive oral AZT; 19% and 10% did not receive intravenous AZT; 8% and 7% of babies did not receive oral AZT. The vertical transmission rate was 5,6% varying from 2,9% to 7,5% between cities and being higher in vaginal delivers (8%) and non-elective caesarian section (7%). CONCLUSIONS: Brazilian Program for Reducing HIV Vertical Transmission is vulnerable due to the lack of organization, administration and evaluation in the health services. A model-guidance is suggested with steps necessary for a better understanding in all levels of these managerial steps.
HIV; Disease transmission; vertical; Pregnancy; Prenatal care; Program evaluation; Parturition
