Inequalities in access to HIV and syphilis tests in prenatal care in Brazil

Dados Bibliográficos

ID5166959
AutoresClaudia Helena Soares De Morais Freitas (0000-0003-0265-5396, Universidade Federal da Paraíba), Franklin Dellano Soares Forte (0000-0003-4237-0184, Universidade Federal da Paraíba), Maria Helena Rodrigues Galvão (0000-0003-1344-2863, Universidade Federal do Rio Grande do Norte), Ardigleusa Alves Coelho (0000-0001-8869-3793, Universidade Estadual da Paraíba), Angelo Giuseppe Roncalli (0000-0001-5311-697X, Universidade Federal do Rio Grande do Norte), Sonia Maria Ferreira Dias (0000-0001-5085-0685, Universidade Nova de Lisboa)
Ano2019
Volume35
Fascículo6
Páginase00170918-e00170918
Data de publicação2019-01-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoCadernos de Saude Publica (JOURNAL)
Identificadores do periódicoISSN: 0102-311X • E-ISSN: 1678-4464
EditoraFapUNIFESP (SciELO) (PUBLISHER)
DOI10.1590/0102-311x00170918
PMID31166542
OpenAlexW2947651556
SCIELO_PIDS0102-311X2019000705003
IdiomaEN
Citações recebidas8
Referências citadas29

This study aims to evaluate the social determinants of access to HIV and VDRL tests during pregnancy in Brazil. The dependent variables were based on prenatal care access: prenatal care appointments, no HIV and syphilis tests. The independent variables at the first level were formal education level, age, race, work and participation in the Family Income program conditional cash transfer program. The city-level variables were the human development index (HDI), Gini index, and indicators related to health services. An exploratory analysis was performed assessing the effect of each level through prevalence ratios (PR) calculation. A multilevel mixed-effect Poisson regression model was constructed for all outcomes to verify the effect of individual level and with both the individual and contextual levels. Regarding prenatal appointments, the main implicated factors were related to individual socioeconomic position (education level and participation in the Family Income Program conditional cash transfer program), however only HDI maintained significance for the city-level context. The city-level variance dropped from 0.049 to 0.042, indicating an important between-city effect. Regarding the outcomes performing tests in prenatal care, the worst conditions such as contextual (HDI > 0.694, p 8 years of schooling, p < 0.001) showed a risk effect in the final model. Variables related to health services did not show significant effects. They were associated with individual socioeconomic position and a city-level contextual effect. These findings indicate the importance of strengthening HIV and syphilis infection control programs during pregnancy

Conditional cash transfer · Context (archaeology) · Environmental health · Geography · Poisson regression · Population · Poverty · Prenatal care · Socioeconomic status · Sociology · Adolescent Sexual and Reproductive Health · Demography · Global Maternal and Child Health · Maternal and Neonatal Healthcare · Medicine · Gerontology