Trends and characteristics of AIDS mortality in the Rio de Janeiro city after the introduction of highly active antiretroviral therapy

We examined the characteristics of AIDS mortality in Rio de Janeiro city from 1995 to 2003. During this period, highly active antiretroviral therapy with protease inhibitors was made available, and it changed the pattern of the epidemics. There was a 47.5 percent reduction in the number of AIDS deaths within the period, with an increase in the proportion of women among the deceased; their schooling was lower than that of the men, similar to the trends of the national-level epidemics. The main place of death changed from university hospitals to emergency rooms. The proportion of cases reported to the National Diseases Surveillance System (SINAN) reported only through the death certificate remained high. Although there is free distribution of antiretrovirals by the public health system, many patients still lack access to diagnosis and treatment. We need to give priority to access to anti-HIV testing and treatment, to increase the quality of care and to look into the issue of adherence in order to further reduce AIDS mortality.

Pobreza, desigualdades sociais e AIDS: tendencias e perspectivas de intervenção pública / poverty, social inequalities, and AIDS: trends and perspectives for public intervention

A noção de cidadania e a consolidação democrática buscam equacionar os dilemas da desigualdade social e da pobreza. No entanto, no contexto brasileiro, o perfil de distribuição dos beneficios sociais, e a magnitude e heterogeneidade das situações de privação e carência desafiam o ideal de igualdade e a perspectiva universalista de direitos sociais. No campo da saúde, os distintos perfis epidemiológicos expressam as diferenças na distribuição e organização dos serviços, as desigualdades regionais relativas ao acesso da população e a vulnerabilidade da imensa parcela de pobres e indigentes. Examinam-se aqui as interfaces entre pobreza, desigualdades e Aids, privilegiando a reflexão sobre projetos de intervenção e desenhos institucionais alternativos