TRANSMISSÃO VERTICAL DO HIV NO PERÍODO PÓS-PARTO: reflexões sobre ações preventivas

Abstract

It is crucial to identify how care providers in the HIV transmission chain can address the issues caused by this infection as a matter of public health and thus improve its indicators. Vertical transmission is the main cause of HIV acquisition in children, and breastfeeding contributes to a substantial portion of new cases. The mechanism by which this occurs has not been fully elucidated, and scientific evidence does not support the understanding that maternal viral suppression leads to the end of transmission through breastfeeding, although it indicates a relative decrease in risk. Therefore, the paradigm that undetectable equals untransmittable, attributed to other forms of transmission, is broken. This study focuses on a case in which the mother followed all protocols proposed by the Ministry of Health, but postnatal HIV infection was diagnosed in her profile. This highlights a gap in the diagnostic testing process, especially during the post-conception period, within the Brazilian public healthcare system. It is emphasized that programs need to review and regularly use their data to select and optimize the implementation of HIV testing service approaches. In addition to the importance of involving the partner in prenatal consultations and discussions on sexual and reproductive health, this can help identify possible virus exposures, facilitate testing, and ensure that both partners receive the necessary support. These are key strategies to achieve the goals of the decade and the elimination of vertical transmission proposed by the World Health Organization.