Specialized care for people with AIDS in the state of Ceara, Brazil

Abstract

OBJECTIVE To analyze if the distribution of specialized care services for HIV/AIDS is associated with AIDS rates.METHODS Ecological study, for which the distribution of 10 specialized care services in the Ceara state, Northeastern Brazil, was obtained, and the mean rates of the disease were estimated per mesoregion. We evaluated 7,896 individuals who had been diagnosed with AIDS, were aged 13 years or older, lived in Ceara, and had been informed of their condition between 2001 and 2011. Maps were constructed to verify the relationship between the distribution of AIDS cases and institutionalized support networks in the 2001-2006 and 2007-2011 periods. BoxMap and LisaMap were used for data analysis. The Voronoi diagram was applied for the distribution of the studied services.RESULTS Specialized care services concentrated in AIDS clusters in the metropolitan area. The Noroeste Cearense and west of the Sertoes Cearenses had high AIDS rates, but a low number of specialized care services over time. Two of these services were implemented where clusters of the disease exist in the second period. The application of the Voronoi diagram showed that the specialized care services located outside the metropolitan area covered a large territory. We identified one polygon that had no services.CONCLUSIONS The scenario of AIDS cases spread away from major urban areas demands the creation of social support services in areas other than the capital and the metropolitan area of the state; this can reduce access barriers to these institutions. It is necessary to create specialized care services for HIV/AIDS in the Noroeste Cearense and north of Jaguaribe.

Análise espacial da sífilis em gestantes e sífilis congênita no estado do Espírito Santo, 2011-2018*

“…However, analysis of the syphilis case maps for the state and its municipalities showed non-random SP and CS spatial distribution, as well as a significant cluster patter, proven by Moran's index and also visually evident, both on the SP map and also on the CS map; the geographical evidence of the data gathered points to high risk of occurrence of the disease in the metropolitan region of Vitória and on the state's north coast. This conclusion is similar to the findings of Pedrosa et al, 18 whose study conducted in 2015 in the state of Ceará regarding spatial distribution of the human immunodeficiency virus (HIV) -an infection with similar transmission to that of syphilis -, identified the same spatial cluster model, both on the coast and in the metropolitan region of the state capital Fortaleza. 18 With regard to the main cluster on the CS map, it can be suggested that a probable cause is the existence of shortcomings in prenatal care.…”

“…This conclusion is similar to the findings of Pedrosa et al, 18 whose study conducted in 2015 in the state of Ceará regarding spatial distribution of the human immunodeficiency virus (HIV) -an infection with similar transmission to that of syphilis -, identified the same spatial cluster model, both on the coast and in the metropolitan region of the state capital Fortaleza. 18 With regard to the main cluster on the CS map, it can be suggested that a probable cause is the existence of shortcomings in prenatal care. 2,5,8,[19][20][21] The CS incidence rate is an indicator capable of pointing to flaws in prenatal care.…”

Suporte Social e HIV: Relações Entre Características Clínicas, Sociodemográficas e Adesão ao Tratamento

“…O suporte social pode influenciar de forma direta -disponibilização de encorajamento, reforço positivo e motivação para o autocuidado -, e indireta, ao atenuar estímulos que interferem negativamente sobre a adesão. Outros estudos também relataram a relação entre apoio social e bem-estar psicológico com a conduta de adesão à terapia antirretroviral (Gonzalez et al, 2004;Lopes et al, 2014;Oliveira et al, 2015;Pedrosa et al, 2015).…”

Epidemiologia da mortalidade neonatal no Ceará no período de 2005-2015

“…O índice de Moran global é uma medida de correlação espacial usada para avaliar até que ponto o nível de uma variável para uma determinada área é similar às áreas vizinhas. Varia no intervalo de -1 a +1, sendo os valores próximos a zero de ausência de correlação espacial e, quando positivos, indicam existência de áreas com valores similares (13) . Realizou-se ainda regressão linear da TMI geral e dos componentes neonatal precoce e tardio para verificar a tendência.…”