Spatial analysis of HIV detection rates among Brazilian young men, 2007-2021.

The main goal of this study was to spatially analyze the HIV epidemic scenario in young men in Brazil, 2007-2021. We used secondary data obtained from the Brazilian Information System for Notifiable Diseases. Individuals aged 15-29 years with permanent residence in Brazil who were diagnosed with HIV during the study period were included in the analysis. Municipality HIV age-adjusted detection rates were analyzed through spatial distribution, autocorrelation, and spatiotemporal risk analyses. During the study period, 108,392 HIV cases were reported in young Brazilian men. The HIV epidemic increased territorially in the northern, northeastern, midwestern, and southeastern regions but decreased in the southern region. Although the number of clusters comprising municipalities with high HIV detection rates (hotspots) decreased, new ones appeared, expanded, or stopped changing size. Hotspots and spatio-temporal risk zones (spatial areas with increased HIV detection in a specific period) comprised economically developed municipalities with high demographic density surrounded by less developed municipalities. The period of the spatiotemporal risk zones was between 2008 and 2021. Our study showed that HIV detection rates continue to increase among young Brazilian men, and health authorities should reinforce efforts mainly in capitals and surrounded municipalities in the north, northeast, southeast, and midwest regions.

Spatial analysis of the AIDS mortality rate among young people in a province of the Brazilian Amazon: An ecological study.

Worldwide, policies to combat human immunodeficiency virus (HIV) have led to a small decrease in the acquired immunodeficiency syndrome (AIDS) mortality rate among young people. For greater policy efficacy, it is necessary to determine the influence of social determinants of health (SDHs) in each territory. The objective of this study was to spatially analyse the AIDS mortality rate among young people in a province of the Brazilian Amazon and the spatial variability of the rate promoted by SDHs. All reports of AIDS deaths between 2007 and 2018 among young people living in the state of Pará were included in the study. The mortality rate was analysed using spatial distribution and autocorrelation, spatial scanning, and geographically weighted regression (GWR). During the study period, there were 1,372 deaths from AIDS among young people with a territorial expansion. The spatial autocorrelation showed two high-high clusters in the period from 2007 to 2010, one formed by municipalities in south-eastern Pará and one in the metropolitan region of Belém, with only the latter remaining between 2011 and 2018. This region showed a higher spatial risk for AIDS mortality and was the only cluster with spatiotemporal risk in the 2013-2018 period. Spatial variability was promoted by the i) the youth homicide rate, ii) the elementary school dropout rate and iii) the number of families registered in the Unified Registry for Social Programs (CadÚnico). This study provides support for the implementation of effective focal policies to combat HIV and reduce the mortality rate among young people in Pará.

Spatial variability of mother-to-child human immunodeficiency virus transmission in a province in the Brazilian Rainforest: An ecological study.

The mother-to-child transmission (MTCT) of the human immunodeficiency virus (HIV) remains a serious public health problem in the Brazilian Rainforest. This study aimed to spatially analyze this type of infection between 2007 and 2018 in Pará, which is the second-largest Brazilian state in the Brazilian Rainforest and also has the highest MTCT of HIV in Brazil. We analyzed the incidence rates of HIV (including the acquired immunodeficiency syndrome (AIDS) by MTCT as the main route of infection in children younger than 13 years old and whose mothers live in Pará. We employed spatial autocorrelation, spatial scanning, and geographic-weighted spatial regression techniques. In the period of this study, 389 new HIV/AIDS were noted, with territorial expansion of the incidence rates in the municipalities in northern and southern Pará having the highest rates. São Francisco do Pará had high spatial risk and high-spatiotemporal risk clusters comprising municipalities in western and south-western Pará between 2013 and 2016. The spatial variability of HIV/AIDS incidence rates was found to be common in the number of men and women with formal jobs; unemployed ≥18 years old people; elementary school pupils; and families enrolled in the "Single Registry for Social Programs". The social equity approach in Pará guarantee pregnant women access to preventive, diagnostic and treatment health services and their children should be supported to eliminate the MTCT of HIV in Pará.

HIV epidemic in a province of the Brazilian Amazon region: Temporal trend analysis.

BACKGROUND: Although considerable progress has been made over the last decades, human immunodeficiency virus (HIV) incidence and acquired immunodeficiency syndrome (AIDS) mortality rates have remarkably increased in the Brazilian Amazon region. Here, we employed temporal analysis to determine the impact of public policies on the HIV epidemic in the state of Pará, Brazil, which has the second highest HIV incidence rate in the Amazon region. DESIGN AND METHODS: This is an ecological study conducted in the state of Pará, employing secondary data of HIV/AIDS cases notified to the Information System for Notifiable Diseases, 2007-2018. The following epidemiological variables were collected: year of notification, municipality of residence, age, sex, education, exposure category, and HIV/AIDS diagnostic criteria. The study population was composed of 21,504 HIV/AIDS cases. The HIV/AIDS incidence rates were analyzed employing the temporal trend analysis (TTA) followed by the chi-square test and residue analysis to determine the association between the epidemiological variables and time series periods. RESULTS: A total of 50% of the notifications were composed of AIDS cases. TTA identified two periods in HIV/AIDS incidence, with stabilization of cases in the first period (G1, 2007-2012) and an upward trend in the second period (G2, 2012-2018). The most prevalent epidemiological characteristics in G2 (versus G1) were as follows: young people, brown skin color, higher schooling, and homosexuals. CONCLUSIONS: Public policy to control HIV infection in the Brazilian Amazon region has been partially effective. HIV screening tests and treatment should be made widely available to eradicate HIV infection in the Amazon region by 2030.