Análise espacial da epidemia do HIV entre mulheres brasileiras

Abstract

INTRODUCTION: The detection rate of Human Immunodeficiency Virus (HIV) among women has been decreasing in recent years. However, an epidemiological diagnosis at the national level is necessary to detail this behavior of the epidemic in this population, since the Acquired Immunodeficiency Syndrome (AIDS) remains the main cause of mortality among women aged 15 to 49 years. OBJECTIVE: To spatially analyze the historical scenario of the HIV epidemic in Brazil, among women from 15 years of age, from 2007 to 2020. METHODOLOGICAL DESIGN: Ecological study that used secondary databases of the Information System of Notifiable Diseases considering as unit of analysis the 5,570 Brazilian municipalities. All cases of HIV and AIDS among women living in Brazil were considered. The following spatial analysis techniques were used: 1) Spatial Distribution, 2) Spatial Autocorrelation and 3) Spatio-temporal risk analysis. RESULTS: There was a territorial decrease in the HIV epidemic throughout Brazil, but less decrease in the North, Northeast and Midwest regions. There was a decrease in the number of hotspost clusters (neighboring municipalities with a high incidence rate) throughout Brazil. However, some consolidated with expansion or contraction. Bahia, Paraná and Piauí were the only Brazilian states with coldspot clusters (neighboring municipalities with a low incidence rate), with Piauí standing out with the greatest expansion of this grouping. The South and Southeast regions presented spatio-temporal risks earlier than the other regions and all risk zones had in their compositions state capitals and most of them included adjacent municipalities. CONCLUSION: Although cluster hotspots have decreased in number, others have consolidated and new hotspots have also emerged. This study provides subsidies for the implementation of more effective and focused public policies to combat HIV among Brazilian women. There is a need to include municipal and state authorities in the planning of policies against HIV, always respecting the regional characteristics and each Brazilian municipality.