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We investigated 2 scenarios: \u201ccurrent access\u201d (89.1% receive one ANC syphilis test and 41.1% receive 2; 81.7% receive one ANC HIV test and 18.9% receive birth testing; if diagnosed, 81.0% are treated for syphilis and 87.5% are treated for HIV) and \u201cideal access\u201d (95% of women undergo 2 HIV and syphilis screenings; 95% receive appropriate treatment). We conducted univariate and multivariate sensitivity analyses on key inputs.<\/jats:p><jats:p>Results. \u2003With current access, we projected 2.95 CS cases\/1000 LB, 0.29 HIV infections\/1000 LB, 7.1% HIV MTCT risk, and 11.11 intrauterine fetal demises (IUFD)\/1000 pregnancies, with significant regional variation. With ideal access, we projected improved outcomes: 1.00 CS cases\/1000 LB, 0.10 HIV infections\/1000 LB, HIV MTCT risk of 2.4%, and 10.65 IUFD\/1000 pregnancies. Increased testing drove the greatest improvements. Even with ideal access, only HIV infections\/1000 LB met elimination goals. Achieving all targets required testing and treatment &amp;gt;95% and reductions in prevalence and incidence of HIV and syphilis.<\/jats:p><jats:p>Conclusions. \u2003Increasing access to care and HIV and syphilis antenatal testing will substantially reduce HIV and syphilis MTCT in Brazil. In addition, regionally tailored interventions reducing syphilis incidence and prevalence and supporting HIV treatment adherence are necessary to completely meet elimination goals.<\/jats:p>","DOI":"10.1093\/ofid\/ofv073","type":"journal-article","created":{"date-parts":[[2015,5,23]],"date-time":"2015-05-23T01:12:04Z","timestamp":1432343524000},"source":"Crossref","is-referenced-by-count":13,"title":["Prenatal Transmission of Syphilis and Human Immunodeficiency Virus in Brazil: Achieving Regional Targets for Elimination"],"prefix":"10.1093","volume":"2","author":[{"given":"Rodrigo","family":"Cerda","sequence":"first","affiliation":[{"name":"Divisions of General Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Freddy","family":"Perez","sequence":"additional","affiliation":[{"name":"Communicable Diseases and Health Analysis Department, HIV, Hepatitis, Tuberculosis and Sexually Transmitted Infections Unit, Pan American Health Organization, Washington DC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosa Maria S.M.","family":"Domingues","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula M.","family":"Luz","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatriz","family":"Grinsztejn","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valdilea G.","family":"Veloso","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonja","family":"Caffe","sequence":"additional","affiliation":[{"name":"Communicable Diseases and Health Analysis Department, HIV, Hepatitis, Tuberculosis and Sexually Transmitted Infections Unit, Pan American Health Organization, Washington DC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordan A.","family":"Francke","sequence":"additional","affiliation":[{"name":"Divisions of General Medicine"},{"name":"Medical Practice Evaluation Center, Department of Medicine, Massachusetts General Hospital, Boston"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth A.","family":"Freedberg","sequence":"additional","affiliation":[{"name":"Divisions of General Medicine"},{"name":"Medical Practice Evaluation Center, Department of Medicine, Massachusetts General Hospital, Boston"},{"name":"Divisions of Infectious Diseases"},{"name":"Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea L.","family":"Ciaranello","sequence":"additional","affiliation":[{"name":"Medical Practice Evaluation Center, Department of Medicine, Massachusetts General Hospital, Boston"},{"name":"Divisions of Infectious Diseases"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2015,5,22]]},"reference":[{"key":"2020081009164210000_OFV073C1","article-title":"Epidemiological profiles of neglected diseases and other infectious diseases related to poverty in Latin America and the Caribbean","author":"Pan American Health Organization","year":"2009"},{"key":"2020081009164210000_OFV073C2","article-title":"Progress Report 2011: Global HIV\/AIDS response: epidemic update and health sector progress towards universal access","author":"World Health 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