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Reconstruindo a epidemia de AIDS entre usu??rios de drogas injet??veis brasileiros

By Mariana de Andrea Vilas-Boas Hacker, I??ri da Costa Leite, Adrian Renton, Tania Guill??n de Torres, Renata Gracie and Francisco In??cio Pinkusfeld Monteiro Bastos

Abstract

A epidemia de HIV/AIDS entre usu??rios de drogas injet??veis (UDIs) apresenta, no Brasil, contrastes temporais e geogr??ficos. Esta an??lise explora tais complexidades, com o emprego de modelagem multin??vel. As taxas padronizadas de incid??ncia de AIDS em UDIs para os munic??pios brasileiros (per??odo 1986-2000) foram consideradas como vari??vel-dependente, e um conjunto de indicadores sociais como covari??veis. Em alguns Estados do Norte e Nordeste, a epidemia ?? incipiente entre UDIs, enquanto a epidemia paulista atinge uma rede de munic??pios, a maioria deles distantes da capital.Mais recentemente, e em menor escala, dissemina????o an??loga foi observada nos Estados mais meridionais. As covari??veis ???n??mero de m??dicos por habitante??? e ???dist??ncia-padr??o da capital do respectivo estado??? se mostraram associadas ?? vari??veldependente. Os casos de AIDS entre UDIs parecem se concentrar em munic??pios mais ricos e bem equipados. O peso relativo dessa dissemina????o extensa em Estados- chave, populosos, prevalece sobre o conjunto da epidemia brasileira, definindo uma faixa que se estende do Centro-oeste ao Sudeste, com munic??pios mais ricos, de m??dio porte, e, mais recentemente, uma faixa sul de munic??pios substancialmente afetados pela epidemia entre UDIs.The HIV/AIDS epidemic among injection drug users (IDUs) in Brazil has been unique in terms of temporal and geographical contrasts. This analysis explores these contrasts through the use of multilevel modeling. Standardized AIDS incidence rates among IDUs for Brazilian municipalities (1986-2000) were used as the dependent variable, with a set of social indicators as independent variables (covariates). In some States of the North/Northeast, the epidemic among IDUs has been incipient. The S??o Paulo epidemic extended to reach a network of municipalities, most of which located far from the capital. More recently, on a smaller scale, a similar extension has been observed in the southernmost States of the country. Both ???number of physicians per inhabitant??? and ???standard distance to the State capital??? were found to be associated with AIDS incidence. AIDS cases among IDUs appeared to cluster in wealthier,more developed municipalities. The relative weight of such extensive dissemination in key, heavily populated States prevails in the Brazilian IDU epidemic, defining a central-western-southeastern strip of wealthier middle-sized municipalities and more recently a southern strip of municipalities deeply affected by the epidemic in this population

Topics: Uso Indevido de Drogas Parenterais, S??ndrome de Imunodefici??ncia Adquirida, Distribui????o Espacial, Incid??ncia, Intravenous Substance Abuse, Acquired Immunodeficiency Syndrome, Residence Characteristics, Incidence
Publisher: Escola Nacional de Sa??de P??blica, Funda????o Oswaldo Cruz
Year: 2010
OAI identifier: oai:agregador.ibict.br.RI_FIOCRUZ:oai:localhost:icict/540
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