1 / 19

Rodrigo Zilli Haanwinckel

Prevention of vertical transmission of HIV in Brazil. Rodrigo Zilli Haanwinckel Ministry of Health of Brazil Health Surveillance Secretariat Department of STD, AIDS and Hepatitis. Brazil. Population – 190 million 27 States Municipalities - 5,561 Area: 8,5 million sq km. 3.

ayoka
Télécharger la présentation

Rodrigo Zilli Haanwinckel

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Prevention of vertical transmission of HIV in Brazil Rodrigo ZilliHaanwinckel Ministry of Health of BrazilHealth Surveillance SecretariatDepartment of STD, AIDS and Hepatitis

  2. Brazil • Population – 190 million • 27 States • Municipalities - 5,561 • Area: 8,5 million sq km 3

  3. SUS - NationalHealth System • Federal law # 8080 (1988) - NationalHealth System (SUS) established – “health as a citizen’srightandthegovernment’sduty” - freeand universal access to healthcare • 100% of Brazilian people have the right to access the National Health System, including the prisoners.

  4. HIV: General Data. Brazil, Estimate nr of PLHA 620,000 Prevalence : 0.61% (pop. 15 to 49 years old) fem:0.42% male:0.80%

  5. DetectionofPregnantWomenwith HIV/aids (cases andincidence rate/100,000 livebirths), byyear. Brazil, 2005-2009(1) FONTE: MS/ SVS/ Departamento de DST, Aids e Hepatites Virais NOTA: (1) Casos notificados no Sinan até 30/06/2010 (2) Utilizados nascidos vivos no ano de 2008 Dados preliminares para os últimos 5 anos

  6. Reported Cases of MCT of HIV in childrenlessthanfiveyears-old.

  7. Incidence rate of AIDS (by 100,000 inhabitants) in childrenlessthan 5 years-oldbyBrazilianregionandyearofdiagnosis. Brazil, 1997 to 2009. 14,0 12,0 10,0 8,0 Incidence rate 6,0 4,0 2,0 0,0 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Year of diagnosis Brazil North Northeast Southeast South Midwest FONTE: MS/SVS/Departamento de DST Aids e Hepatites Virais. POPULAÇÃO: MS/SE/DATASUS em <www.datasus.gov.br> no menu informações em saúde > Demográfica e socioeconômicas, acessado em 20/10/2009. NOTA: (1) Casos notificados no SINAN e registrados no SISCEL/SICLOM até 30/06/2009 e SIM de 2000 a 2008. Dados preliminares para os últimos cinco anos.

  8. Antiretroviraldrugsuniversallyavailable in Brazil NTRI PI • ZIDOVUDINE (1993)* • ESTAVUDINE (1997)* • DIDANOSINE (1998)* • LAMIVUDINE (1999)* • ABACAVIR (2001) • DIDANOSINE EC (2005) • TENOFOVIR (2003)-2011* • RITONAVIR (1996)* • SAQUINAVIR (1996)* • INDINAVIR (1997)* • NELFINAVIR (1998) • AMPRENAVIR (2001) • LOPINAVIR/r (2002) • ATAZANAVIR (2004) • DARUNAVIR (2008) • TIPRANAVIR (2010) NNTRI • NEVIRAPINE (2001)* • EFAVIRENZ (1999)-2007* • ETRAVIRINE (2011) FUSION INHIBITOR • ENFUVIRTIDE (2005) INTEGRASE INHIBITOR *Brazilian local production (10 out of 21) Year of introduction in parenthesis • RALTEGRAVIR (2009)

  9. Brazilian Penitentiary System Scenario (Dec/2011): • Incarcerated population: 471,254 • 441,907 (94%) – Men • 29,347 (6%) – Women • 1,779 penal facilities – 4 federal prisons

  10. Prevalenceof HIV/AIDS in female in prision:

  11. Increasing vulnerability context • Confining Conditions • Overcrowding • Inadequate facilities • Difficulties in accessing prevention and hygiene materials (condoms, lubricants, toothbrushes, shavers) • Violence • Poor health care • Limited access to information • Practices that increase vulnerability • Drug Use • Unprotected sex • Sharing of tattoo and piercing equipment

  12. The Brazilian Response to HIV & AIDS • Is focused on principles of protection and human rights; • Universal access; • Is structured by the Policy of Attention to Incarcerated Individuals; • Is based on integral attention and access to prevention materials (condoms, ART and testing); • Multisectoral actions.

  13. HIV & AIDS in the Penitentiary System National Actions • National Plan for Health in the Penitentiary System, 2003 • Regional Consultation for Latin America and the Caribbean on HIV & AIDS in Prison Settings, 2008 • National Consultation on HIV & AIDS in Prison Settings, 2009 • Technical Cooperation Project – Ministry of Health, Penitentiary System Authority and UNODC: HIV & AIDS prevention and assistance - Strengthening health care in the penitentiary system. • National Plan for Health in the Penitentiary System - Revision

  14. National Plan for Health in the Penitentiary System Purpose: Organize the access of inmates to public health services Targeted population: 100% of Brazilian inmates 18 Brazilian states qualified and developing

  15. Health Network Prevention: Prevention commodities (condoms and harm reduction kits) Breast milk substitute for exposed children Medication to inhibit breast milk production Hepatitis B vaccination Diagnosis: Testing (HIV, STD, TB, hepatitis B and C) Follow-up procedures: viral load, CD4, genotype Treatment: ART Treatment for opportunistic infections; STD treatment

  16. Operational Plan for The Reduction of MCT of HIV and Syphilis Goals: • Reducing HIV MCT rate to less than 1% • Eradicating congenital syphilis (<1 case/1,000) nationwide. • Main achievement: • From 1997 to 2009: 49% reduction in the incidence rate of AIDS cases in children under 5 years old.

  17. Challenges • Organization of the health care network • Access to prevention materials • Access to diagnosis and specialized care to women in prision • Monitoring of the PMCT in this population • Human rights as a key issue to reduce vulnerabilities

  18. THANK YOU! FAÇA O TESTE DE AIDS, SÍFILIS E HEPATITE rodrigo.zilli@aids.gov.br

More Related