Análise espacial da mortalidade por Aids entre jovens no Pará e os impactos dos determinantes sociais de saúde

Abstract

Introduction: Worldwide, AIDS control policies have led to a small decrease in the mortality rate among young people, which is only 6% among young males. For a better effectiveness of these policies, it is necessary to take into account the influence of social determinants of health (SDH) on the mortality rate in each territory. Objective: To spatially analyze the AIDS mortality rate among young people in the state of Pará and the spatial variability of the rate promoted by the DSS from 2007 to 2018. Method: Ecological study using secondary data from the Mortality Information System (SIM). All notifications of AIDS deaths in young people residing in the state of Pará between 2007 and 2018 were included in the study. The mortality rate was analyzed using spatial distribution and autocorrelation, spatial scanning, and geographically weighted regression (GWR). Results: During the study period, 1,372 AIDS deaths were reported among young people from Pará. The AIDS mortality rate showed territorial expansion. Spatial autocorrelation showed two high­-high clusters in the period from 2007 to 2010, one formed by municipalities in the southeast of Pará and the other in the metropolitan region of Belém (RMB), with only the cluster of RMB remaining between 2011 and 2018. The RMB presented the highest spatial risk for AIDS mortality and the only one with the spatio-­temporal risk in the period 2013­-2018. The spatial variability of the AIDS mortality rate was promoted by the "homicide rate among young people", "elementary school dropout rate" and "by the number of families registered in CADÚNICO". Conclusion: This study covers the Amazonian particularities that involve AIDS mortality among young people from Pará, allowing the spatial identification of the involvement of rate variability promoted by the DSS.