Health system strategies to increase HIV screening among pregnant women in Mesoamerica.
Popul Health Metr
; 16(1): 5, 2018 03 20.
Article
em En
| MEDLINE
| ID: mdl-29554930
BACKGROUND: To propose health system strategies to meeting the World Health Organization (WHO) recommendations on HIV screening through antenatal care (ANC) services, we assessed predictors of HIV screening, and simulated the impact of changes in these predictors on the probability of HIV screening in Guatemala, Honduras, Mexico (State of Chiapas), Nicaragua, Panama, and El Salvador. METHODS: We interviewed a representative sample of women of reproductive age from the poorest Mesoamerican areas on ANC services, including HIV screening. We used a multivariate logistic regression model to examine correlates of HIV screening. First differences in expected probabilities of HIV screening were simulated for health system correlates that were associated with HIV screening. RESULTS: Overall, 40.7% of women were screened for HIV during their last pregnancy through ANC. This rate was highest in El Salvador and lowest in Guatemala. The probability of HIV screening increased with education, household expenditure, the number of ANC visits, and the type of health care attendant of ANC visits. If all women were to be attended by a nurse, or a physician, and were to receive at least four ANC visits, the probability of HIV screening would increase by 12.5% to reach 45.8%. CONCLUSIONS: To meet WHO's recommendations for HIV screening, special attention should be given to the poorest and least educated women to ensure health equity and progress toward an HIV-free generation. In parallel, health systems should be strengthened in terms of testing and human resources to ensure that every pregnant woman gets screened for HIV. A 12.5% increase in HIV screening would require a minimum of four ANC visits and an appropriate professional attendance of these visits.
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Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Pobreza
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Complicações Infecciosas na Gravidez
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Cuidado Pré-Natal
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Qualidade da Assistência à Saúde
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Infecções por HIV
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Programas de Rastreamento
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Promoção da Saúde
Tipo de estudo:
Diagnostic_studies
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Prognostic_studies
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Risk_factors_studies
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Screening_studies
Limite:
Adult
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Female
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Humans
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Pregnancy
País como assunto:
America central
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El salvador
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Guatemala
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Honduras
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Mexico
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Nicaragua
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Panama
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article