Income determines the impact of cash transfers on HIV/AIDS: cohort study of 22.7 million Brazilians.
Nat Commun
; 15(1): 1307, 2024 Feb 12.
Article
en En
| MEDLINE
| ID: mdl-38346964
ABSTRACT
Living with extremely low-income is an important risk factor for HIV/AIDS and can be mitigated by conditional cash transfers. Using a cohort of 22.7 million low-income individuals during 9 years, we evaluated the effects of the world's largest conditional cash transfer, the Programa Bolsa Família, on HIV/AIDS-related outcomes. Exposure to Programa Bolsa Família was associated with reduced AIDS incidence by 41% (RR0.59; 95%CI0.57-0.61), mortality by 39% (RR0.61; 95%CI0.57-0.64), and case fatality rates by 25% (RR0.75; 95%CI0.66-0.85) in the cohort, and Programa Bolsa Família effects were considerably stronger among individuals of extremely low-income [reduction of 55% for incidence (RR0.45, 95% CI0.42-0.47), 54% mortality (RR0.46, 95% CI0.42-0.49), and 37% case-fatality (RR0.63, 95% CI0.51 -0.76)], decreasing gradually until having no effect in individuals with higher incomes. Similar effects were observed on HIV notification. Programa Bolsa Família impact was also stronger among women and adolescents. Several sensitivity and triangulation analyses demonstrated the robustness of the results. Conditional cash transfers can significantly reduce AIDS morbidity and mortality in extremely vulnerable populations and should be considered an essential intervention to achieve AIDS-related sustainable development goals by 2030.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
11_ODS3_cobertura_universal
/
1_ASSA2030
/
2_ODS3
/
4_TD
Problema de salud:
11_financial_arrangements
/
11_multisectoral_coordination
/
1_doencas_nao_transmissiveis
/
2_cobertura_universal
/
2_enfermedades_transmissibles
/
4_aids
Asunto principal:
Síndrome de Inmunodeficiencia Adquirida
/
Pueblos Sudamericanos
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
Límite:
Adolescent
/
Female
/
Humans
País/Región como asunto:
America do sul
/
Brasil
Idioma:
En
Revista:
Nat Commun
/
Nature communications
Asunto de la revista:
BIOLOGIA
/
CIENCIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Brasil