O trabalho realizado pelo Projeto Transmissão Vertical Zero de Sorocaba, SP, e o elevado número de crianças expostas ao vírus da aids, no país, motivaram a realização deste estudo quanti-qualitativo que teve como objetivo geral compreender a vivência da mãe-pai enquanto aguardam o diagnóstico definitivo do lactente exposto à transmissão vertical do HIV. Esta pesquisa teve como referencial teórico a Antropologia Médica e a Narrativa como referencial metodológico. Os dados foram coletados em 2006. O momento quantitativo do estudo constou de caracterização das gestantes matriculadas no citado Projeto, no período de 1998 a 2004. O momento qualitativo contou com a participação de 11 mães e sete pais de lactentes expostos ao HIV. Os dados nessa fase foram coletados por meio de técnica projetiva (colagem) com gravação dos relatos sobre o sentido atribuído à construção. Com o tratamento dos dados qualitativos, emergiram seis temas: Sentimentos de esperança e confiança; ansiedade e expectativa; Espiritualidade e Religiosidade; Apoio; Preocupação com a saúde do filho; Preconceito e Fazendo analogia, que possibilitaram identificar as expectativas e as ações adotadas pelos pais enquanto aguardavam a confirmação do diagnóstico da criança. Os resultados mostraram que a vivência do núcleo familiar é marcada por intensa mobilização de sentimentos, preocupação com a saúde da criança e crença no tratamento. O preconceito e o estigma à aids revelaram-se como principais fontes estressoras, acarretando sofrimento e sentimento de culpa, que exigem empenho dos pais para se adaptarem ao Enfrentamento a cada nova situação cotidiana. Portanto, o Enfrentamento emergiu como tema central e mostrou que o cotidiano do binômio mãe-pai é vivido com ambigüidade de sentimentos. A tolerância às adversidades e aos transtornos é motivada pela afetividade e dedicação ao filho. A maneira de encarar e resistir ao infortúnio constituiu-se no Enfrentamento que gera atitudes paliativas ou de afastamento do convívio social, representadas pela busca de apoio espiritual e religioso, e também suporte social. Para os binômios atendidos no Projeto Transmissão Vertical Zero, o principal sustentáculo do Enfrentamento diante da indefinição do diagnóstico do filho é representado pela fé religiosa e pela crença em um Ser superior. As implicações destes achados são importantes para a enfermagem, que pode implementar cuidados culturalmente embasados, com a possibilidade de intervenções mais adequadas à clientela / The work carried out by the Zero Vertical Transmission Project in Sorocaba, SP, and the high number of children exposed to the aids virus in the country motivated this quantitative/qualitative study whose general objective is to understand the experience the parents live while waiting for the definite diagnosis of the infant exposed to the HIV vertical transmission. This research had the Medical Anthropology as theoretical reference and the Narrative as methodological reference. The data were collected in 2006. The study quantitative moment was when we characterized the pregnant women enrolled in the above mentioned project, from 1998 to 2004. The qualitative moment counted on the participation of 11 mothers and 7 fathers of infants exposed to the HIV. The data in this phase were collected through the projective technique (collage) with recording of the reports about the meaning attributed to the construction. When treating the qualitative data, six topics came up : Hope and confidence feelings; Anxiety and expectation; Spirituality and religiosity; Support; Concerns about the child\'s health; Prejudice and Making an analogy, which enabled us to identify the expectations and actions adopted by the parents while waiting for the child\'s diagnosis confirmation. The results showed that the family nucleus experience is characterized by an intense mobilization of feelings, concern about the child\'s health and belief in the treatment. The prejudice and stigma to aids turned out to be the main stressful sources, causing suffering and a sense of guilt that the parents have to struggle against to adjust to the Coping in each daily new situation. Therefore, the Coping came up as the central theme and showed that the daily life of the binomial mother-father is lived with ambiguity of feelings. Accepting the adversity and the disorders is motivated by the affection and dedication to the child. The way to face and withstand the misfortune made up the Coping that generates palliative attitudes or social isolation, represented by the search for spiritual and religious support, besides the social support. For the binomial attended in the Zero Vertical Transmission Project, the main strength for the Coping while the child\'s diagnosis is not defined is represented by the religious faith and by the belief in a Superior Being. These findings\' implications are important for the nursing which may implement a care based on the culture, with the possibility of interventions more suitable to the customers

O trabalho realizado pelo Projeto Transmissão Vertical Zero de Sorocaba, SP, e o elevado número de crianças expostas ao vírus da aids, no país, motivaram a realização deste estudo quanti-qualitativo que teve como objetivo geral compreender a vivência da mãe-pai enquanto aguardam o diagnóstico definitivo do lactente exposto à transmissão vertical do HIV. Esta pesquisa teve como referencial teórico a Antropologia Médica e a Narrativa como referencial metodológico. Os dados foram coletados em 2006. O momento quantitativo do estudo constou de caracterização das gestantes matriculadas no citado Projeto, no período de 1998 a 2004. O momento qualitativo contou com a participação de 11 mães e sete pais de lactentes expostos ao HIV. Os dados nessa fase foram coletados por meio de técnica projetiva (colagem) com gravação dos relatos sobre o sentido atribuído à construção. Com o tratamento dos dados qualitativos, emergiram seis temas: Sentimentos de esperança e confiança; ansiedade e expectativa; Espiritualidade e Religiosidade; Apoio; Preocupação com a saúde do filho; Preconceito e Fazendo analogia, que possibilitaram identificar as expectativas e as ações adotadas pelos pais enquanto aguardavam a confirmação do diagnóstico da criança. Os resultados mostraram que a vivência do núcleo familiar é marcada por intensa mobilização de sentimentos, preocupação com a saúde da criança e crença no tratamento. O preconceito e o estigma à aids revelaram-se como principais fontes estressoras, acarretando sofrimento e sentimento de culpa, que exigem empenho dos pais para se adaptarem ao Enfrentamento a cada nova situação cotidiana. Portanto, o Enfrentamento emergiu como tema central e mostrou que o cotidiano do binômio mãe-pai é vivido com ambigüidade de sentimentos. A tolerância às adversidades e aos transtornos é motivada pela afetividade e dedicação ao filho. A maneira de encarar e resistir ao infortúnio constituiu-se no Enfrentamento que gera atitudes paliativas ou de afastamento do convívio social, representadas pela busca de apoio espiritual e religioso, e também suporte social. Para os binômios atendidos no Projeto Transmissão Vertical Zero, o principal sustentáculo do Enfrentamento diante da indefinição do diagnóstico do filho é representado pela fé religiosa e pela crença em um Ser superior. As implicações destes achados são importantes para a enfermagem, que pode implementar cuidados culturalmente embasados, com a possibilidade de intervenções mais adequadas à clientela / The work carried out by the Zero Vertical Transmission Project in Sorocaba, SP, and the high number of children exposed to the aids virus in the country motivated this quantitative/qualitative study whose general objective is to understand the experience the parents live while waiting for the definite diagnosis of the infant exposed to the HIV vertical transmission. This research had the Medical Anthropology as theoretical reference and the Narrative as methodological reference. The data were collected in 2006. The study quantitative moment was when we characterized the pregnant women enrolled in the above mentioned project, from 1998 to 2004. The qualitative moment counted on the participation of 11 mothers and 7 fathers of infants exposed to the HIV. The data in this phase were collected through the projective technique (collage) with recording of the reports about the meaning attributed to the construction. When treating the qualitative data, six topics came up : Hope and confidence feelings; Anxiety and expectation; Spirituality and religiosity; Support; Concerns about the child\'s health; Prejudice and Making an analogy, which enabled us to identify the expectations and actions adopted by the parents while waiting for the child\'s diagnosis confirmation. The results showed that the family nucleus experience is characterized by an intense mobilization of feelings, concern about the child\'s health and belief in the treatment. The prejudice and stigma to aids turned out to be the main stressful sources, causing suffering and a sense of guilt that the parents have to struggle against to adjust to the Coping in each daily new situation. Therefore, the Coping came up as the central theme and showed that the daily life of the binomial mother-father is lived with ambiguity of feelings. Accepting the adversity and the disorders is motivated by the affection and dedication to the child. The way to face and withstand the misfortune made up the Coping that generates palliative attitudes or social isolation, represented by the search for spiritual and religious support, besides the social support. For the binomial attended in the Zero Vertical Transmission Project, the main strength for the Coping while the child\'s diagnosis is not defined is represented by the religious faith and by the belief in a Superior Being. These findings\' implications are important for the nursing which may implement a care based on the culture, with the possibility of interventions more suitable to the customers

nÃo hà / Objetivou-se com esta pesquisa construir uma escala de avaliaÃÃo da capacidade para cuidar de crianÃas expostas ao HIV (EACCC-HIV); elaborar itens e dimensÃes e avaliar as propriedades psicomÃtricas em termos de validade e confiabilidade do instrumento. A validade de conteÃdo da EACCC-HIV foi verificada pela concordÃncia entre os juÃzes (opiniÃo de cinco especialistas) e a anÃlise semÃntica por um professor de portuguÃs e tÃcnica de brainstorming. Na validade do construto comparou-se os grupos contrastados. Para a confiabilidade da escala utilizaram-se o alfa de cronbach e o teste-reteste. A pesquisa foi do tipo metodolÃgica com abordagem quantitativa, realizada em duas unidades de referÃncia no atendimento de crianÃas expostas ao HIV em Fortaleza-CE. A amostra aplicada no piloto foi constituÃda de 26 cuidadores de crianÃas expostas ao HIV. Quanto ao desenvolvimento metodolÃgico, ocorreu de fevereiro a outubro de 2008, e neste foram utilizados como instrumentos a escala inicial com 55 itens, a escala para o piloto com 70 itens e os formulÃrios para avaliaÃÃo com os juÃzes. Conforme os resultados revelaram, nos 55 itens iniciais uma concordÃncia de 98,5% (p=0,470) entre os juÃzes. No entanto, 32 itens foram mantidos, um excluÃdo e 16 incluÃdos, ficando o total de 70 itens para aplicaÃÃo no piloto. ApÃs a anÃlise semÃntica, 14 itens foram reformulados. Com 70 itens, o instrumento piloto foi aplicado na amostra de 26 cuidadores de crianÃas expostas ao HIV. A maioria dos cuidadores tinha entre 20 e 29 anos; convivia com o parceiro, a metade tinha o ensino fundamental completo e incompleto, grande parte estava desempregada e recebia menos de um salÃrio mÃnimo. Nos grupos contrastados, identificou-se nÃo ter havido associaÃÃo estatisticamente significante entre a variÃvel renda e 49 itens da escala. Existiu, porÃm, associaÃÃo significante ou valor limÃtrofe em sete itens (p<0,05). Neste caso sugere-se a variÃvel renda na aplicaÃÃo desta escala em outras pesquisas. A confiabilidade pelo alfa de cronbach apresentou valor total de 0,954 e p=0,0001. Portanto, houve consistÃncia interna dos itens, mas para o teste-reteste nÃo foi possÃvel realizar testes estatÃsticos. Na segunda fase com os juÃzes, o alfa de cronbach total para claridade, relaÃÃo dimensÃo-item e relevÃncia obteve-se o valor de 0,800 e p=0,0001, demonstrando concordÃncia entre eles. Contudo, na anÃlise para a claridade do item nÃo se observou equivalÃncia (&#945;=0,110 e p=0,262) e alguns itens do instrumento foram reformulados ou excluÃdos. Elaborou-se no final a EACCC-HIV com 52 itens e cinco dimensÃes. ApÃs a realizaÃÃo do estudo, obteve-se um instrumento confiÃvel capaz de avaliar a capacidade para cuidar de crianÃas expostas ao HIV. Este poderà ser usado amplamente na clÃnica e na pesquisa, e assim, contribuirà para a realizaÃÃo de estudos futuros com esta temÃtica. Sugere-se, ainda, a aplicaÃÃo da EACCC-HIV em amostras maiores e com testes de associaÃÃo com as variÃveis maternas e infantis, a fim de verificar a confiabilidade e a validade do instrumento com novos pesquisadores e chegar a uma escala estÃvel e replicÃvel / It was objectified with this research to construct a scale of evaluation of the capacity to take care of children displayed to HIV (EACCC-HIV); to elaborate item and dimensions and to evaluate the psychometric properties in validity terms and trustworthiness of the instrument. The validity of content of the EACCC-HIV was verified by the agreement enters the judges (opinion of five specialists) and the semantics analysis by Portuguese teacher and technique of Brainstorming. In the validity of construct were compared the contrasted groups. For the trustworthiness of the scale the Alpha of Cronbach and the test-retest had been used. The research was of the methodological type with quantitative boarding, carried through in two units of reference in the attendance of children displayed to the HIV in Fortaleza-CE. The sample applied in the pilot was constituted of 26 caregivers of children displayed to the HIV. How much to the methodological development, occurred of February to October of 2008, and in this had been used as instruments the initial scale with 55 item, the scale for the pilot with 70 item and the forms for evaluation with the judges. As the results had disclosed, in the 55 initial item an agreement of 98,5% (p=0,470) between the judges. However, 32 item had been kept, one excluded and 16 enclosed ones, being the total of 70 item for application in the pilot. After the semantics analysis, 14 item had been reformulated. With 70 item, the pilot instrument was applied in the sample of 26 caregivers of children displayed to the HIV. The majority of the caregivers had between 20 and 29 years; it coexisted the partner, the half had complete basic education and incomplete, great part was dismissed and received less from one minimum wage. In the contrasted groups, it was identified that not to have had statistical significant association between the changeable income and 49 item of the scale. It existed, however, significant association or bordering value in seven item (p<0,05). In this in case that it is suggested changeable income in the application of this scale in other research. The trustworthiness for the Alpha of Cronbach presented total value of 0,954 and p=0,0001. Therefore, it had internal consistency of the item, but for the test-retest it was not possible to carry through statistical tests. In the second phase with the judges, the total Alpha of Cronbach for clarity, relation dimension-item and relevance got the value of 0,800 and p=0.0001, demonstrating agreement between them. However, in the analysis for the clarity of the item equivalence was not observed (&#945;=0,110 and p=0,262) and some item of the instrument had been reformulated or excluded. It was elaborated in the end the EACCC-HIV with 52 item and five dimensions. After the accomplishment of the study, got a trustworthy instrument capable to evaluate the capacity to take care of children displayed to the HIV. This could widely be used in the clinic and in the research, and, thus, it will contribute for the accomplishment of future studies with this thematic one. It is suggested, still, the application of the EACCC-HIV in bigger samples and with tests of association with the infantile and maternal variable and, in order to verify the trustworthiness and the validity of the instrument with new researchers and to arrive at a steady and reapplicable scale

Insects are host to a diverse range of vertically transmitted micro-organisms, but while their bacterial symbionts are well-studied, little is known about their vertically transmitted viruses. The sigma virus (DMelSV) is currently the only natural hostspecific pathogen to be described in Drosophila melanogaster. In this thesis I have examined; the diversity and evolution of sigma viruses in Drosophila, their transmission and population dynamics, and their ability to host shift. I have described six new rhabdoviruses in five Drosophila species — D. affinis, D. obscura, D. tristis, D. immigrans and D. ananassae — and one in a member of the Muscidae, Muscina stabulans (Chapters two and four). These viruses have been tentatively named as DAffSV, DObsSV, DTriSV, DImmSV, DAnaSV and MStaSV respectively. I sequenced the complete genomes of DObsSV and DMelSV, the L gene from DAffSV and partial L gene sequences from the other viruses. Using this new sequence data I created a phylogeny of the rhabdoviruses (Chapter two). The sigma viruses form a distinct clade which is closely related to the Dimarhabdovirus supergroup, and the high levels of divergence between these viruses suggest that they may deserve to be recognised as a new genus. Furthermore, this analysis produced the most robustly supported phylogeny of the Rhabdoviridae to date, allowing me to reconstruct the major transitions that have occurred during the evolution of the family. This data suggests that the bias towards research into plants and vertebrates means that much of the diversity of rhabdoviruses has been missed, and rhabdoviruses may be common pathogens of insects. In Chapter three I examined whether the new sigma viruses in Drosophila affinis and Drosophila obscura are both vertically transmitted. As is the case for DMelSV, both males and females can transmit these viruses to their offspring. Males transmit lower viral titres through sperm than females transmit through eggs, and a lower proportion of their offspring become infected. I then examined natural populations of D. obscura in the UK; 39% of flies were infected and the viral population shows clear evidence of a recent expansion, with extremely low genetic diversity and a large excess of rare polymorphisms. Using sequence data I estimate that the virus has swept across the UK within the last ~11 years, during which time the viral population size doubled approximately every 9 months. Using simulations based on lab estimates of transmission rates, I show that the biparental mode of transmission allows the virus to invade and rapidly spread through populations, at rates consistent with those measured in the field. Therefore, as predicted by the simulations, the virus has undergone an extremely rapid and recent increase in population size. In Chapter four I investigated for the first time whether vertically transmitted viruses undergo host shifts or cospeciate with their hosts. Using a phylogenetic approach I show that sigma viruses have switched between hosts during their evolutionary history. These results suggest that sigma virus infections may be short-lived in a given host lineage, so that their long-term persistence relies on rare horizontal transmission events between hosts. In Chapter five I examined the ability of three Drosophila sigma viruses to persist and replicate in 51 hosts sampled across the Drosophilidae phylogeny. I used a phylogenetic mixed model to account for the non-independence of host taxa due to common ancestry, which additionally allows integration over the uncertainty in the host phylogeny. In two out of the three viruses there was a negative correlation between viral titre and genetic distance from the natural host. Additionally the host phylogeny explains an extremely high proportion of the variation (after considering genetic distance from the natural host) in the ability of these viruses to replicate in novel hosts (>0.8 for all viruses). There were strong phylogenetic correlations between all the viruses (>0.65 for all pairs), suggesting a given species’ level of resistance to one virus is strongly correlated with its resistance to other viruses. This suggests the host phylogeny, and genetic distance from the natural host, may be important in determining viruses ability to host switch. This work has aimed to address fundamental questions relating to host-parasite coevolution and pathogen emergence. The data presented suggests that sigma viruses are likely to be widespread vertically transmitted insect viruses, which have dynamic interactions with their hosts. These viruses appear to have switched between hosts during their evolutionary history and it is likely the host phylogeny is a determinant of such host shifts.

Diss. (sammanfattning) Umeå : Univ., 2007. / Härtill 6 uppsatser.

Orientador: Helaine Maria Besteli Pires Milanez / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-14T07:08:24Z (GMT). No. of bitstreams: 1 Delicio_AdrianeMaira.pdf: 1826833 bytes, checksum: bc3f2dce3447c00fccb97f45337d0f78 (MD5) Previous issue date: 2009 / Resumo: Objetivo: avaliar a transmissão vertical (TV) do HIV e fatores associados em gestantes soropositivas acompanhadas em um serviço universitário brasileiro (CAISM/UNICAMP) entre 2000 e 2009. Sujeitos e Métodos: coorte histórica de 452 gestações e seus recém-nascidos. Os dados foram coletados dos prontuários e registrados em fichas específicas. Crianças sem seguimento foram convocadas para definição diagnóstica. Análise dos dados: análise descritiva através de distribuição percentual e de médias; teste de X², exato de Fisher, t de Student, Mann-Whitney e ANOVA, razão de risco e intervalo de confiança. Resultados: A TV foi de 3,6%. A idade média das gestantes foi 27 anos; principal categoria de exposição foi a sexual (86,5%); 55% já apresentava o diagnóstico prévio à gravidez. Sessenta e dois por cento não estavam em uso de TARV ao engravidar. CD4 médio inicial foi de 474 células/ml e 70.3% apresentaram carga viral indetectável no terceiro trimestre. Como TARV, 55% usaram esquemas com IP e 35% com nevirapina. Monoterapia com AZT foi utilizada em 5,5%. Idade gestacional média no parto foi de 37,2 semanas e em 92% a via foi cesárea; 97,2% receberam AZT endovenoso. Os fatores associados à TV foram: baixa contagem de CD4, elevada carga viral, tempo reduzido de TARV, presença de alterações gestacionais (anemia, RCF, oligoâmnio), coinfecções durante o pré-natal (CMV e toxoplasmose) e presença de trabalho de parto. Uso de TARV potente, parto por cesárea e uso do AZT pelo RN foram fatores protetores. Má adesão ao tratamento esteve presente em 13 dos 15 casos infectados; em sete houve presença de coinfecção neonatal (CMV e toxoplasmose). Conclusão: Fatores de risco para TV foram comprometimento do estado imunológico da gestante, menor tempo de terapia, coinfecções (CMV e toxoplasmose) e presença de trabalho de parto. O uso de TARV potente e a realização de cesárea foram fatores protetores para a TV do HIV. / Abstract: Objectives: to evaluate mother-to-child transmission (MTCT) rates and related factors in HIV-infected pregnant women from CAISM/UNICAMP between 2000 and 2009. Subjects and methods: cohort of 452 HIV-infected pregnant women and their newborns. Data was collected from recorded files and undiagnosed children were enrolled for investigation. Statistical analysis: qui-square test, Fisher exact test, Student t test, Mann-Whitney test, ANOVA, risk ratio and confidence intervals. Results: MTCT occurred in 3.6%. The study population displayed a mean age of 27 years; 86.5% were found to have acquired HIV through sexual contact; 55% were aware of the diagnosis prior to the pregnancy; 62% were not using HAART. Mean CD4 cell-count was 474 cells/ml and 70.3% had undetectable viral loads in the third trimester. HAART included nevirapine in 35% of cases and protease inhibitors in 55%; Zidovudine monotherapy was used in 5.5%. Mean gestational age at delivery was 37.2 weeks and in 92% by caesarian section; 97.2% received intravenous zidovudine. Implicated factors related to MTCT were: low CD4 cell counts, elevated viral loads, maternal aids, shorter periods receiving HAART, maternal concurring illnesses (anemia, IUGR, oligodydramnium), coinfections (CMV and toxoplasmosis) and the occurrence of labor. Use of HAART for longer periods, caesarian delivery and oral zidovudine for the newborns were associated with a decreased risk. Poor adhesion to treatment was present in 13 of the 15 cases of transmission; in 7, co-infections were diagnosed (CMV and toxoplasmosis). Conclusion: Use of HAART and caesarian delivery are protective factors in mother-to-child transmission of HIV. Maternal coinfecctions and maternal concurring illnesses were risk factors for MTCT. / Universidade Estadual de Campi / Ciencias Biomedicas / Mestre em Tocoginecologia

A dissertation submitted to the Faculty of Health Sciences, University of Witwatersrand, Johannesburg in fulfillment of the requirements for the degree of Master of Science in Medicine, Johannesburg , 2013 / South Africa’s Prevention of Mother-to-Child Transmission (PMTCT) programme is critical for eliminating vertical HIV transmission and reducing infant mortality. Early treatment of HIV-infection to curb infant deaths requires earlier diagnostic testing than the currently recommended six-week test. This study describes the continuum of PMTCT care at a Johannesburg hospital to identify interventions for improvement and investigates birth HIV testing for infants. Data from a cohort study at the hospital evaluating diagnostic assays in HIV-exposed infants were collated with routine clinical data, validated and analysed. Among 838 mother-infant pairs, 38% of mothers attended antenatal clinics early enough to receive optimal antenatal prophylaxis. Only 72% of infants accessed six-week testing at the hospital; a further 10% underwent testing elsewhere. Of 38 HIV-infected infants, 29 were infected in-utero and could have been identified at birth (sensitivity of 76.3% for birth testing), compared to only 26 (68%) diagnosed by six-week testing at the hospital. Majority (88%) of these 26 infants accessed antiretroviral therapy, but treatment was only initiated at a median age of 16.0 weeks and 43% of HIV-infected infants who initiated treatment had defaulted or died before the end of the study. Mathematical modelling demonstrated that birth testing would be superior to a six-week test to maximise infants diagnosed and life years saved, with the ideal algorithm being a birth and ten-week test. The PMTCT programme can be enhanced by earlier antenatal care for women and earlier infant diagnosis. Birth testing would diagnose HIV-infection before infants die or default from the PMTCT programme, thereby enabling effective monitoring of MTCT, and would allow earlier treatment initiation to reduce early infant mortality.

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 5 uppsatser.

Source: Dissertation Abstracts International, Volume: 70-07, Section: B, page: 4122. Adviser: John Michael Swint. Includes bibliographical references

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / As mulheres em idade fÃrtil tÃm sido alvo da contaminaÃÃo pelo vÃrus da imunodeficiÃncia adquirida (HIV), o que requer atenÃÃo especial, principalmente na gestaÃÃo, pois hà o risco da transmissÃo vertical (TV) do HIV. A terapia combinada de alta potÃncia se mostrou decisiva na reduÃÃo da taxa de TV, porÃm as medidas de controle nÃo sÃo satisfatÃrias. Objetivou-se avaliar as aÃÃes de controle da TV do HIV em uma maternidade pÃblica. Trata-se de pesquisa do tipo descritiva, exploratÃria e avaliativa. Para abordagem do estudo utilizou-se a complementaridade da pesquisa qualitativa e quantitativa. Coletou-se os dados na Maternidade Escola Assis Chateaubriand (MEAC), localizada em Fortaleza-CearÃ, no perÃodo de setembro a dezembro de 2004. A populaÃÃo do estudo constou de oito puÃrperas com infecÃÃo pelo HIV e oito profissionais que prestaram assistÃncia a estas puÃrperas. Utilizou-se como tÃcnicas de coleta de dados a observaÃÃo estruturada e a entrevista, que seguiram um roteiro de observaÃÃo estruturada e um roteiro de entrevista semi-estruturada. Os dados quantitativos foram analisados e dispostos em tabelas; e os qualitativos analisados e organizados atravÃs da proposta de anÃlise de conteÃdo. Obedeceu-se os aspectos Ãticos da pesquisa com seres humanos, uma vez que todos os sujeitos assinaram o termo de consentimento livre e esclarecido. A maioria das puÃrperas tinha entre 22 e 29 anos, era solteira, com uniÃo estÃvel e procedente do interior, possuÃa baixa escolaridade, tinha entre um e dois filhos; sabia do diagnÃstico a menos de um ano, informou seis ou mais consultas de prÃ-natal e participou de acompanhamento especializado. Pouca parcela das gestantes iniciou a terapia anti-retroviral no perÃodo recomendado e sabia informar sobre a sorologia do parceiro. A maternidade disponibilizou o tratamento para todas as gestantes no momento do trabalho de parto e no parto. Seis profissionais de saÃde que prestava assistÃncia era enfermeiro, encontrava-se entre 26 e 49 anos de idade, a maioria fez referÃncia ao tempo de formaÃÃo entre um e nove anos e de trabalho na maternidade entre um e 15 anos; a minoria recebeu algum tipo de treinamento sobre TV. Identificou-se que os profissionais de saÃde deixaram de realizar aconselhamento e orientaÃÃes sobre preparo da fÃrmula infantil, alimentos e seguimento do recÃm-nascido, sobre consulta puerperal e adesÃo ao tratamento. A instituiÃÃo tinha quantidade insuficiente de alguns insumos, como atadura e inibidor de lactaÃÃo, e centralizava o preenchimento das fichas de investigaÃÃo no nÃcleo de vigilÃncia epidemiolÃgica. Estes resultados nortearÃo o planejamento de intervenÃÃes para futuras aÃÃes, com vistas à melhoria da qualidade na assistÃncia Ãs gestantes com HIV/aids. Sugere-se a criaÃÃo de uma estrutura organizacional e funcional para a implementaÃÃo de protocolos, capacitaÃÃes, reuniÃes de avaliaÃÃo, atuaÃÃo responsÃvel dos enfermeiros, determinaÃÃo de fluxo de atendimento e elaboraÃÃo de um manual direcionado aos profissionais de saÃde. / The women in fertile age have been target of the contamination for the HIV, what it requires special attention, mainly in the gestation, therefore there is the risk of the vertical transmission (VT) of the HIV. The agreed therapy of high power showed decisive in the reduction of the VT tax, however the measures of control are not satisfactory. It was objectified to evaluate the actions of control the VT of the HIV in a public maternity. One is about research, descriptive, exploratory and avaliative type. For boarding of the study it was used complementation of the qualitative and quantitative research. The data were collected in Assis Chateaubriand School Maternity (MEAC), located in Fortaleza-CearÃ, in period of September to December of 2004. The populationâs study consisted of eight postpartum women with infection for the HIV and eight professionals who had given assistance to these postpartum women. The structuralized or standardized comment and the interview were used as techniques. As instruments for the dataâs collection, a script of structuralized comment and a script of half-structuralized interview. The quantitative data had been analyzed and made use in figures; end the qualitative ones analyzed and organized through the proposal of content analysis. It obeyed the ethical aspects of the research with human beings and all the subjects had signed the term of free and clarified assent. The majority of postpartum women had between 22 and 29 years, was single, with steady union, and originating the country, there was low study, had between one and two children; it known of the diagnosis to less of one year, informed six or more prenatalâs consultations of and participated of specialized accompaniment. Little parcel of the pregnant initiated the antiretroviral therapy in the recommended period and to inform about partnerâs serology. The maternity disposed the treatment for all the pregnant women at the moment of the childbirth work and in the childbirth. The majority of the health professionals that gave assistance was nurse, between 26 and 49 years and make reference at time of formation between one and nine years and of work in the maternity between one and 15 years; the minority received some type of training about VT. It was identified that professionals of health had left to realized advice and orientation about preparation of the infantile formula, foods and pursuing of the new-born, about puerperal consultation and adhesion to the treatment. The institution had insufficient amount of some resourchs and centered the fulfilling of the inquiry fiches. It was concluded that these results will guide in the planning of interventions for future actions, with sights to the improvement of the quality in the assistance to the pregnant women with HIV/aids. It is suggested creation of a organizacional and functional structure for the implementation of the protocol, qualifications, meetings of evaluation, responsible performance of the nurses, determination of attendance flow and elaboration of a manual directed to the professionals of health.