Human Immunodeficiency Virus (HIV) Infection in Pregnant Women Living in a Northeastern Brazilian State: Detection and Geographical Distribution (2014–2023)

Abstract

Objective: To analyze the detection rate of the human immunodeficiency virus (HIV) in pregnant women and its geographical distribution according to Health Regions in the state of Maranhão, Brazil, from 2014 to 2023. Method: Ecological, observational, and descriptive study developed from secondary data obtained from TABNET/DATASUS. All pregnant women notified with HIV infection during the study period were included. Detection rates per 1,000 live births and annual averages per Health Region were calculated. Descriptive analyses, Pearson’s correlation, and spatial distribution assessment were performed. Results: A total of 2,437 notifications were recorded during the study period, decreasing from 281 cases (11.5%) in 2014 to 116 cases (4.8%) in 2023, representing a reduction of 58.26%. The state detection rate increased from 2.27 in 2014 to 2.89 in 2023, with a difference of +0.62. The correlation between rate and year was positive but not significant (r=0.337; p=0.341). Among the Health Regions, rates ranged from 0.10 to 8.15, with higher averages in São Luís (3.61), Pinheiro (3.61), and Açailândia (3.56), and lower averages in Pedreiras (1.10) and Bacabal (1.15), revealing a relevant geographic inequality. In 2020, the rate decreased from 2.45 (2019) to 2.08, coinciding with the COVID-19 pandemic period, followed by an increase in 2021 (2.86). Conclusion: There was a decline in notifications and an increase in the detection rate, with marked geographic variation and temporal influence of the pandemic. These findings highlight the need to expand coverage and quality of HIV testing during prenatal care and to strengthen notification and surveillance