How many AIDS epidemics can occur in São Paulo city?

Abstract

OBJECTIVE An ecological study describring the spatial characteristics of AIDS in São Paulo city between 2001 and 2010 according to the place of residence of reported cases in adults.METHODS The AIDS reported cases (28,146), grouped by sex, were geocodified (25,969) and linked with a census tract database (18,953). Case and population at risk data supplied spatial cluster identification and relative risk estimate by the scan method, using the discrete Poisson model. Incidence rate and proportional distribution allowed comparing people living in the high-risk clusters areas to other locations by age, race/ethnicity, schooling and transmission category.RESULTS The AIDS incidence rate decreased in both sexes except among young men and older people. The identification of spatial high-risk clusters showed that the decrease of AIDS did not occur in the same way in the city. Clusters located in the central area presented the highest AIDS incidence rates (245.7/100,000 men), especially among black women (RR = 7.9), men who have sex with men (66.2%) and injection drug users (10.7%) participation. In peripheral clusters, identified only in the female population, the epidemic can be related to the poverty of these women (22.5% low education level). Residents in the north and central-south areas of the city are generally black, with little schooling, and predominantly heterosexually infected.CONCLUSIONS The study of spatial clusters using a census tract helps to determine epidemiological patterns inside the city and in specific populations. Spatial stratification and key population epidemiological patterns were identified in four regions in São Paulo city.

Aids em homens no município de São Paulo, 1980–2012

“…This study sought to identify spatial and space-time clusters of AIDS in men aged 13 years or older in the city of São Paulo, from the first case in 1980 to June 2012. Several methods analyze global and local clusters, with differences in performance in terms of power and precision 4 – 6 , 9 – 19 . In this study, the scanning method was chosen, with the objective of identifying locations with high concentration of AIDS in men.…”

“…Este estudo procurou identificar aglomerados espaciais e espaço-temporais de aids em homens com 13 anos de idade ou mais no município de São Paulo, desde o aparecimento do primeiro caso, em 1980, até junho de 2012. Diversos métodos analisam a aglomeração global e local, com diferenças de desempenho em termos de poder e precisão 4 – 6 , 9 – 19 . No presente, optou-se pelo método de varredura, tendo em vista o objetivo de identificar localidades com alta concentração de aids em homens.…”

“…Some statistical methods help detect relevant disease clusters due to actual effects and not chance, helping in the allocation of resources 8 . Several approaches to HIV/AIDS using spatial and space-time scanning analysis techniques have been explored by different authors, in studies conducted in African countries 6 , 9 – 11 , as well as in the United States 12 , 13 , Canada 14 , , China 15 and Brazil 1 , 4 , 5 , 16 – 19 .…”

Tendência e distribuição espacial de doenças infecciosas em gestantes no estado do Paraná-Brasil

“…Analysis of AIDS cases in Brazil showed an increase in incidence, especially in the Southeast, South and Mid-West regions 21 . Factors associated with HIV infection include income, inadequate prenatal care, multiplicity of sexual partners, race/color black, homosexuality, unprotected sex, injecting drug use, blood transfusion, and accidents with sharp objects in health professionals 22-23 . In addition to these factors, women of reproductive age and, consequently, women in the gestational period, with a threat to the health of the newborn are also at risk for HIV infection, as identified in a study in Mozambique where children from infected mothers had a higher risk of prematurity, malnutrition, hospitalizations and death 24 .…”

“A prevenção não sobe a Augusta”: homossexualidade, HIV, “risco” e produção de fronteiras na região central da cidade de São Paulo

“…Grosso modo, a literatura científica recente sobre a epidemia de HIV destaca o incremento de casos de infecção e suas articulações com raça, idade, gênero, sexualidade e espacialidades (Aguiar et al, 2018), assim como de situações de discriminação e violência em função da orientação sexual (Guimarães et al, 2018). Isso nos parece sugerir a necessidade de investigar com mais cuidado as articulações entre idade/geração, cor/raça, classe e identidade sexual em conexão com os espaços da cidade e com a oferta e o acesso às políticas de prevenção.…”