Análise espacial da epidemia de HIV entre homens jovens no Brasil: um estudo ecológico

Abstract

Introduction: Globally, it is estimated that for every seven new human immunodeficiency virus (HIV) infections, two occur among young people. Spatial analysis studies are essential tools in the fight against HIV. Objective: To spatially analyze the Brazilian historical scenario of the HIV epidemic among young men, from 2007 to 2021. Methods: An ecological study that used secondary databases from the Notifiable Diseases Information System. All cases of HIV and immunologically acquired disease syndrome (AIDS) among men between 15 and 29 years of age and with fixed residence in Brazil were considered. The 5,570 Brazilian municipalities were considered as the unit of analysis and the HIV/AIDS incidence rate standardized by age group as a variable. The following spatial analysis techniques were used: 1) Spatial Distribution, 2) Spatial Autocorrelation and 3) Spatial Scan. Results: 108,392 cases of HIV were reported in Brazil among young men during the study period. The Southeast Region had the highest incidence rates, followed by the Northeast, South, North and Midwest regions. The HIV epidemic showed territorial expansion in all Brazilian regions, with the exception of the southern region, which contracted. Although there has been a decrease in the number of hotspots in all regions, in the North and Northeast regions there has been an expansion in the size of hotspots. There was no expansion of coldspots in the regions. The space-time risk zones were comprised between 2015 and 2021 and all were formed by state capitals and surrounding municipalities. Conclusion: The different behaviors of the HIV epidemic in Brazilian regions may be associated with different regional sociopolitical scenarios. The consolidation, expansion and emergence of new hotspots point to locations where the fight against HIV among young people should be strengthened. The space-time risk analysis shows that the highest HIV detection rates occur in municipalities with higher demographic densities, and the long time period suggests fragility in policies to combat the virus. For the elimination of HIV, greater integration of municipalities, states and the federal government is necessary in the search for greater social equity.