Navegando por Assunto "Acquired immunodeficiency syndrome"

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Epidemia do HIV e os determinantes sociais em saúde entre jovens no contexto amazônico: análise geograficamente ponderada e projeções temporais
(Universidade Federal do Pará, 2022-07-11) PEDROSO, Andrey Oeiras; NOGUEIRA, Laura Maria Vidal; http://lattes.cnpq.br/9020674768816530; https://orcid.org/0000-0003-0065-4509; BOTELHO, Eliã Pinheiro; http://lattes.cnpq.br/6276864906384922; https://orcid.org/0000-0002-9682-6530
Introduction: In Brazil, the HIV/AIDS detection rate (/100,000 inhab.) showed a decrease in the general population of 17.2%, from 2009 (21.5) to 2019 (17.8). However, this rate increased substantially among the young population, which had the highest detection rate in the country, 52.0 (/100,000 inhab.) (BRASIL, 2020a). This advance on the young population is due to obstructions, discrimination, inequalities, stigmas and social and health inequities, intrinsic vulnerabilities of this population stratum that enhance their chances of becoming infected with HIV. However, the risk of HIV infection cannot be conditioned only to the individual, since behaviors are directly influenced by socioeconomic territorial factors that exceed the individual. Despite all the advancement of HIV among young people, there is a scarcity of studies aimed at analyzing the impact of Social Determinants of Health (SDH) on the epidemic in this age group. Objective: To analyze temporally and spatially the HIV epidemic among young people in the State of Pará. Methods: An ecological study that analyzed HIV/AIDS cases diagnosed between 2007 and 2018 in Pará, Brazil. An exploratory analysis was performed using descriptive statistics. The temporal projections (2019-2022) used mixed method, ARIMA + STL in the RStudio software. For the spatial analysis, we used statistical scanning techniques to obtain the Relative Risk (RR), with a confidence interval of 95%; Moran's autocorrelation statistic considering statistically significant (p < 0.05) for building the LISAMap in ArcGIS software. In SPSS software, we developed models from Ordinary Least Squares (OLS) and later by Geographically Weighted Regression (GWR), with spatial analysis of residuals, with the help of MGWR and ArcGIS software. Results: Of the 8,143 cases analyzed, 47.97% were young people between 25 and 29 years old, men (66.46%), mixed race (76.95%), living in urban areas (85.20%) and heterosexuals (54 .41%). An expansion of HIV among young people in Pará was identified, with a temporal projection of increase for young people aged 20-24 years. Spatial variability of DSS: 'Basic Education Development Index'; doctors per 10,000 inhabitants and municipal high school abandonment (MHSA) rate were associated with the risk of HIV infection among young people. The relative risk showed spatial variability. Conclusions: The SDH associated with HIV risk among young people in Pará, show social particularities of HIV in the study region and should be considered in the formulation of policies to reach the global goal of eliminating AIDS by 2030 among young people.
Acesso aberto (Open Access)
Kaposi’s sarcoma in persons living with HIV/AIDS: a case series in a tertiary referral hospital
(Universidade Federal do Pará, 2018-08) PIRES, Carla Andréa Avelar; NORONHA, Marcos Antônio Neves; MONTEIRO, Julius Caesar Mendes Soares; COSTA, Albert Luiz Costa da; ABREU JUNIOR, José Maria de Castro
Background: Kaposi’s sarcoma (KS) is a rare neoplasm with indolent progression. Since 1981, the Kaposi’s sarcoma epidemic has increased as co-infection with HIV. Objectives: The study aimed to identify the clinical and demographic characteristics and therapeutic approaches in HIV/AIDS patients in a regional referral hospital. Methods: We analyzed the medical records of 51 patients with histopathological diagnosis of Kaposi’s sarcoma hospitalized at Hospital Universitário João de Barros Barreto (HUJBB) from 2004 to 2015. Results: The study sample consisted of individuals 15 to 44 years of age (80.4%), male (80.4%), single (86.3%), and residing in Greater Metropolitan Belém, Pará State, Brazil. The primary skin lesions identified at diagnosis were violaceous macules (45%) and violaceous papules (25%). Visceral involvement was seen in 62.7%, mainly affecting the stomach (75%). The most frequent treatment regimen was 2 NRTI + NNRTI, and 60.8% were referred to chemotherapy. Study limitations: We assumed that more patients had been admitted to hospital without histopathological confirmation or with pathology reports from other services, so that the current study probably underestimated the number of KS cases. Conclusion: Although the cutaneous manifestations in most of these patients were non-exuberant skin lesions like macules and papules, many already showed visceral involvement. Meticulous screening of these patients is thus mandatory, even if the skin lesions are subtle and localized.
Acesso aberto (Open Access)
Morbidade por HIV e AIDS na região amazônida: análise temporal
(Universidade Federal do Pará, 2019-10-30) PINHEIRO, Adriana de Sá; BOTELHO, Eliã Pinheiro; http://lattes.cnpq.br/6276864906384922; https://orcid.org/0000-0002-9682-6530
Introduction: Since the discovery of the Human Immunodeficiency Virus (HIV) and acquired immunodeficiency syndrome (AIDS) in the early 80s, the epidemic has become a serious public health problem due to its rapid worldwide dissemination. In Brazil, although the average detection rate of HIV and AIDS have shown a reduction of 9.4% in the last ten years, the North and Northeast regions showed growth (44.2% and 24.1%, respectively). Pará occupies the 8th position at national level in detection rate of HIV and AIDS (23.6 cases per 100,000 inhab.). Objective: to analyze the historical series of the HIV epidemic in the State of Pará. This study is a ecological time series, in which secondary data collected from the Notification Disease Information System were analyzed between 2007 and 2018 in the 144 municipalities of the State. The following variables were used: gender, age, race / color, education, exposure category and municipality of residence. Only residents in Pará and those over thirteen years old were included in the study. To calculate the incidence rate of HIV and AIDS, the number of new cases of HIV and AIDS among residents over 13 years old was considered as variable, divided by the number of the total population residing in the same age group in the municipalities, regions and state and multiplied the ratio by 100,000. Annual percentage changes (APC) in incidence rates were calculated using Joinpoint modeling. For the analysis of epidemiological variables between the two defined periods, the chisquare test and residual analysis were used. P≤0.05 values were considered statistically significant. Results: The incidence rates of HIV and AIDS in 2007 and 2018 increased by 420%. An inflection point was identified for the series, separating it into two trend periods: 2007 to 2012 (G1) and 2012 to 2018 (G2). In G1, the incidence increased with an annual percentage variation of 1.6% (CI = 15.0 to 21.5; p≤0.05), while in G2, the variation was 29.8% (CI = 19.9 at 40.5; p≤0.05). Changes in age and education profile were observed between G1 and G2: in G1, adults with low levels of education were the most affected by the epidemic, while in G2, the young population with high levels of education. According to the analysis of the HIV infection trends together with the exploration of the socioeconomic dynamics of the municipalities whose HIV cases were more frequent in each of the state's mesoregions (Oriximiná, Belém, Bragança, Abaetetuba, Marabá, Parauapebas and Altamira). The incidence was higher in municipalities with better socioeconomic conditions, but with lower coverage of the Family Health Strategy. Identifying changes in the profile of new infections direct the visualization of key populations, as well as localized epidemics and their dissemination forms for the adoption of public health policies competent for the management of HIV infection.