Factors associated with loss to follow up among HIV-exposed children: a historical cohort study from 2000 to 2017, in Porto Alegre, Brazil
Abstract Background There are many inequalities in terms of prevention and treatment for pregnant women with HIV and exposed children in low and middle-income countries. The Brazilian protocol for prenatal care includes rapid diagnostic testing for HIV, compulsory notification, and monitoring by the...
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| Format: | Article |
| Language: | English |
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BMC
2022-07-01
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| Series: | BMC Public Health |
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| Online Access: | https://doi.org/10.1186/s12889-022-13791-9 |
| _version_ | 1818163028092256256 |
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| author | Karen da Silva Calvo Daniela Riva Knauth Bruna Hentges Andrea Fachel Leal Mariana Alberto da Silva Danielle Lodi Silva Samantha Correa Vasques Letícia Hamester Daila Alena Raenck da Silva Fernanda Vaz Dorneles Fernando Santana Fraga Paulo Ricardo Bobek Luciana Barcellos Teixeira |
| author_facet | Karen da Silva Calvo Daniela Riva Knauth Bruna Hentges Andrea Fachel Leal Mariana Alberto da Silva Danielle Lodi Silva Samantha Correa Vasques Letícia Hamester Daila Alena Raenck da Silva Fernanda Vaz Dorneles Fernando Santana Fraga Paulo Ricardo Bobek Luciana Barcellos Teixeira |
| author_sort | Karen da Silva Calvo |
| collection | DOAJ |
| description | Abstract Background There are many inequalities in terms of prevention and treatment for pregnant women with HIV and exposed children in low and middle-income countries. The Brazilian protocol for prenatal care includes rapid diagnostic testing for HIV, compulsory notification, and monitoring by the epidemiological surveillance of children exposed to HIV until 18 months after delivery. The case is closed after HIV serology results are obtained. Lost to follow-up is defined as a child who was not located at the end of the case, and, therefore, did not have a laboratory diagnosis. Lost to follow-up is a current problem and has been documented in other countries. This study analyzed factors associated with loss to follow-up among HIV-exposed children, including sociodemographic, behavioral, and health variables of mothers of children lost to follow-up. Methods This historical cohort study included information on mothers of children exposed to HIV, born in Porto Alegre, from 2000 to 2017. The research outcome was the classification at the end of the child's follow-up (lost to follow-up or not). Factors associated with loss to follow-up were investigated using the Poisson regression model. Relative Risk calculations were performed. The significance level of 5% was adopted for variables in the adjusted model. Results Of 6,836 children exposed to HIV, 1,763 (25.8%) were classified as lost to follow-up. The factors associated were: maternal age of up to 22 years (aRR 1.25, 95% CI: 1.09–1.43), the mother’s self-declared race/color being black or mixed (aRR 1.13, 95% CI: 1.03–1.25), up to three years of schooling (aRR 1.45, 95% CI: 1.26–1.67), between four and seven years of schooling (aRR 1.14, 95% CI: 1.02–1.28), intravenous drug use (aRR 1.29, 95% CI: 1.12–1.50), and HIV diagnosis during prenatal care or at delivery (aRR 1.37, 95% CI: 1.24–1.52). Conclusion Variables related to individual vulnerability, such as race, age, schooling, and variables related to social and programmatic vulnerability, remain central to reducing loss to follow-up among HIV-exposed children. |
| first_indexed | 2024-12-11T16:43:02Z |
| format | Article |
| id | doaj.art-cebc7db5958148fb8d02b5addf3b93d2 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-11T16:43:02Z |
| publishDate | 2022-07-01 |
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| spelling | doaj.art-cebc7db5958148fb8d02b5addf3b93d22022-12-22T00:58:16ZengBMCBMC Public Health1471-24582022-07-012211810.1186/s12889-022-13791-9Factors associated with loss to follow up among HIV-exposed children: a historical cohort study from 2000 to 2017, in Porto Alegre, BrazilKaren da Silva Calvo0Daniela Riva Knauth1Bruna Hentges2Andrea Fachel Leal3Mariana Alberto da Silva4Danielle Lodi Silva5Samantha Correa Vasques6Letícia Hamester7Daila Alena Raenck da Silva8Fernanda Vaz Dorneles9Fernando Santana Fraga10Paulo Ricardo Bobek11Luciana Barcellos Teixeira12Graduate Studies Program in Public Health, Federal University of Rio Grande Do SulDepartment of Social Medicine, Federal University of Rio Grande Do SulDepartment of Social Medicine, Federal University of Rio Grande Do SulGraduate Studies Program in Public Policy, Federal University of Rio Grande Do SulGraduate Studies Program in Public Health, Federal University of Rio Grande Do SulGraduate Studies Program in Epidemiology, Federal University of Rio Grande Do SulGraduate Studies Program in Public Health, Federal University of Rio Grande Do SulProfessional Master’s in Family Health, Federal University of Rio Grande Do SulSchool of Nursing, Federal University of Rio Grande Do SulGeneral Directorate of Health SurveillanceSchool of Nursing, Federal University of Rio Grande Do SulGraduate Studies Program in Public Health, Federal University of Rio Grande Do SulGraduate Studies Program in Public Health, Federal University of Rio Grande Do SulAbstract Background There are many inequalities in terms of prevention and treatment for pregnant women with HIV and exposed children in low and middle-income countries. The Brazilian protocol for prenatal care includes rapid diagnostic testing for HIV, compulsory notification, and monitoring by the epidemiological surveillance of children exposed to HIV until 18 months after delivery. The case is closed after HIV serology results are obtained. Lost to follow-up is defined as a child who was not located at the end of the case, and, therefore, did not have a laboratory diagnosis. Lost to follow-up is a current problem and has been documented in other countries. This study analyzed factors associated with loss to follow-up among HIV-exposed children, including sociodemographic, behavioral, and health variables of mothers of children lost to follow-up. Methods This historical cohort study included information on mothers of children exposed to HIV, born in Porto Alegre, from 2000 to 2017. The research outcome was the classification at the end of the child's follow-up (lost to follow-up or not). Factors associated with loss to follow-up were investigated using the Poisson regression model. Relative Risk calculations were performed. The significance level of 5% was adopted for variables in the adjusted model. Results Of 6,836 children exposed to HIV, 1,763 (25.8%) were classified as lost to follow-up. The factors associated were: maternal age of up to 22 years (aRR 1.25, 95% CI: 1.09–1.43), the mother’s self-declared race/color being black or mixed (aRR 1.13, 95% CI: 1.03–1.25), up to three years of schooling (aRR 1.45, 95% CI: 1.26–1.67), between four and seven years of schooling (aRR 1.14, 95% CI: 1.02–1.28), intravenous drug use (aRR 1.29, 95% CI: 1.12–1.50), and HIV diagnosis during prenatal care or at delivery (aRR 1.37, 95% CI: 1.24–1.52). Conclusion Variables related to individual vulnerability, such as race, age, schooling, and variables related to social and programmatic vulnerability, remain central to reducing loss to follow-up among HIV-exposed children.https://doi.org/10.1186/s12889-022-13791-9HIV/AIDSChildren exposed to HIVLost to follow-upMother-to-child transmission of HIV |
| spellingShingle | Karen da Silva Calvo Daniela Riva Knauth Bruna Hentges Andrea Fachel Leal Mariana Alberto da Silva Danielle Lodi Silva Samantha Correa Vasques Letícia Hamester Daila Alena Raenck da Silva Fernanda Vaz Dorneles Fernando Santana Fraga Paulo Ricardo Bobek Luciana Barcellos Teixeira Factors associated with loss to follow up among HIV-exposed children: a historical cohort study from 2000 to 2017, in Porto Alegre, Brazil BMC Public Health HIV/AIDS Children exposed to HIV Lost to follow-up Mother-to-child transmission of HIV |
| title | Factors associated with loss to follow up among HIV-exposed children: a historical cohort study from 2000 to 2017, in Porto Alegre, Brazil |
| title_full | Factors associated with loss to follow up among HIV-exposed children: a historical cohort study from 2000 to 2017, in Porto Alegre, Brazil |
| title_fullStr | Factors associated with loss to follow up among HIV-exposed children: a historical cohort study from 2000 to 2017, in Porto Alegre, Brazil |
| title_full_unstemmed | Factors associated with loss to follow up among HIV-exposed children: a historical cohort study from 2000 to 2017, in Porto Alegre, Brazil |
| title_short | Factors associated with loss to follow up among HIV-exposed children: a historical cohort study from 2000 to 2017, in Porto Alegre, Brazil |
| title_sort | factors associated with loss to follow up among hiv exposed children a historical cohort study from 2000 to 2017 in porto alegre brazil |
| topic | HIV/AIDS Children exposed to HIV Lost to follow-up Mother-to-child transmission of HIV |
| url | https://doi.org/10.1186/s12889-022-13791-9 |
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