The HIV Epidemic In Colombia: Spatial And Temporal Trends Analysis

Abstract

BACKGROUND – Colombia occupies 4th place among all Latin American countries in HIV/AIDS incidence rates, which have been increasing since the 1980s. There is a paucity of studies which address this trend. In this study we employed spatial and temporal trend analyses to study how the epidemic behaves in Colombian territory. METHODS - Our sample was composed of 72,994 HIV/AIDS cases and 21,898 AIDS-related deaths reported to the National Ministry of Health between 2008 and 2016. We employed the joinpoint regression model to analyze the annual HIV/AIDS incidence and AIDS mortality rates. In the spatial analysis we used univariate autocorrelation techniques and the Kernel density estimator. RESULTS – While the HIV/AIDS incidence had an increasing trend in Colombia, the AIDS mortality was stabilized. There was a downward trend in HIV/AIDS incidence and AIDS mortality among people between 0 to 14 years of age. An upward trend was observed for HIV/AIDS incidence in people older than 15 years of age and with the highest trend in 65 years and over group. AIDS mortality showed an increased trend in those 65 years old or over. The high-high clusters of HIV/AIDS incidence and AIDS mortality were located in the Andean and Caribbean regions. The HIV epidemic expanded from the North Caribbean region to Midwest Colombia.CONCLUSION – Sexual tourism and internal or external immigration might be responsible for the highest HIV/AIDS incidence and AIDS mortality rates observed in the Caribbean and Andean regions. Our results showed that Colombia needs to invest in specific and comprehensive public health policies to end HIV by 2030.