(P284) HIV and syphilis mother-to-Child Transmission certification process in 43 municipalities above 100,000 inhabitants in Brazil

Wednesday, July 26, 2023

16:00 – 18:00 CST

Primary Presenter(s)

Angélica E. Miranda, MD, PhD (she/her/hers)

Coordinator
Department of HIV/AIDS, Tuberculosis, Viral Hepatitis, and Sexually Transmitted Infections at Brazilian Ministry of Health
Brasilia, Brazil

Co-author(s)

Pamela Cristina Gaspar, MSc

Technical Consultant
Department of HIV/AIDS, Tuberculosis, Viral Hepatitis, and Sexually Transmitted Infections at Brazilian Ministry of Health/ Public Health Postgraduate Program at Brasília University
Brasilia, Distrito Federal, Brazil
GD

Guilherme B. Dias, Ph.D

Data Analyst
Ministry of Health
Brasília, Distrito Federal, Brazil
Al

Aparecida lima

Ministry of Health, United States
MG

Mayra Gonçalves Aragón

Department of HIV/AIDS, Tuberculosis, Viral Hepatitis, and Sexually Transmitted Infections / Ministry of Health / Brasília / Brazil, United States
LL

Leonor Lannoy

Ministry of Health, United States
Angélica E. Miranda, MD, PhD (she/her/hers)

Coordinator
Department of HIV/AIDS, Tuberculosis, Viral Hepatitis, and Sexually Transmitted Infections at Brazilian Ministry of Health
Brasilia, Brazil

Project: The Elimination of Mother-to-Child Transmission (EMTCT) of HIV and Syphilis is a national priority. The recognition of municipalities that achieved the proposed goals through Certification is a strategy to disseminate good practices in EMTCT. In 2017, Brazil launched the HIV EMTCT guide, granting certification to 3 municipalities in 2019. In 2021, Brazil adopted the WHO proposal, for municipalities with ≥100,000 inhabitants, which enables the granting of tiers (gold, silver, and bronze) and EMTCT of HIV and/or Syphilis according to the performance of impact and process indicators, and evaluation of 4 recommended assessments: programs and services, surveillance, diagnostic capacity, and human rights.

Issue: MTCT of HIV/syphilis are an important public health problem due to their impacts on maternal and child health. This is a global challenge that can be prevented and eliminated through timely actions, such as testing, treatment, and specific prophylaxis, in addition to access and quality of prenatal care.

Results: Brazil has 208,000,000 inhabitants, 27 states and 5,570 municipalities. In 2020, 58.6% (122,000,000) of the population resided in 326 municipalities with ≥ 100,000 inhabitants, which account for 66.9% of HIV by MTCT and 75.8% of Congenital Syphilis. In 2022, among municipalities with ≥100,000 inhabitants, 48 (14.7%) and 37 (11.3%) presented indicators for requesting certification, respectively for HIV and Syphilis. Of these, 43 municipalities were granted elimination certificates or tiers, with 17 double certifications, 21 HIV certifications, and 5 Syphilis certifications. Also, there were 3 HIV elimination recertifications (Figure). The total number of certifications corresponded to a territory of 24,626,907 inhabitants. In the process of granting certification, 337 health services were visited (primary health units, street clinics, specialty centers, social assistance centers, maternity hospitals, laboratories, epidemiological surveillance, ombudsman, and community councils) by National Validation Teams, composed of 53 specialists in the 4 recommended assessments.

Lesson Learned: The certification of EMTCT of HIV and/or syphilis gave visibility to the cause and its continuity could contribute to the EMTCT in Brazil. Our main legacy is the local mobilization and reorganization of care and surveillance services. The main challenge is the sustainability and expansion of the process, especially in the North and Northeast regions.