Highly active antiretroviral therapy in Brazil: the challenge of universal access in a context of social inequality
Autor(a) principal: | |
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Data de Publicação: | 2004 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da FIOCRUZ (ARCA) |
Texto Completo: | https://www.arca.fiocruz.br/handle/icict/687 |
Resumo: | Objective. To investigate trends in AIDS mortality and incidence in Brazil over the period of 1984 to 2000 and to assess the impact of the introduction of universal access to highly active antiretroviral therapy (HAART) in the country in 1996. Methods. Data from the Brazilian disease notification system and the national mortality information system were used to calculate annual region-specific and sex-specific AIDS incidence and mortality rates. We also calculated sex- and region-specific ratios of the number of AIDS deaths in one year to the number of AIDS cases notified two years earlier. Results. AIDS mortality rates for both men and women and in all five of the geographic regions of Brazil declined following introduction of HAART, despite continued growth in AIDS incidence. The ratio of the number of AIDS deaths in one year to the number of AIDS cases notified two years earlier for men equalized rapidly with the ratio for women following introduction of HAART. More recently, AIDS incidence declined for both sexes and in most of the regions of Brazil. Conclusions. Despite Brazil’s resource limitations and disparities in wealth between men and women and among the country’s regions, the introduction of universal access to HAART in Brazil has helped achieve impressive declines in AIDS mortality, and it may also be contributing to declines in AIDS incidence. |
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Vilas-Boas Hacker, Mariana de AndreaPetersen, Maya L.Enriquez, MelissaBastos, Francisco Inácio Pinkusfeld Monteiro2010-08-23T16:58:39Z2010-11-04T14:19:43Z2010-08-23T16:58:39Z2010-11-04T14:19:43Z2004VILAS-BOAS Hacker, Mariana de Andrea et al. Highly active antiretroviral therapy in Brazil: the challenge of universal access in a context of social inequality. Revista Panamericana de Salud Pública / Pan American Journal of Public Health, Washington, v. 16, n. 2, p. 78-83, 2004.1020-4989https://www.arca.fiocruz.br/handle/icict/687Objective. To investigate trends in AIDS mortality and incidence in Brazil over the period of 1984 to 2000 and to assess the impact of the introduction of universal access to highly active antiretroviral therapy (HAART) in the country in 1996. Methods. Data from the Brazilian disease notification system and the national mortality information system were used to calculate annual region-specific and sex-specific AIDS incidence and mortality rates. We also calculated sex- and region-specific ratios of the number of AIDS deaths in one year to the number of AIDS cases notified two years earlier. Results. AIDS mortality rates for both men and women and in all five of the geographic regions of Brazil declined following introduction of HAART, despite continued growth in AIDS incidence. The ratio of the number of AIDS deaths in one year to the number of AIDS cases notified two years earlier for men equalized rapidly with the ratio for women following introduction of HAART. More recently, AIDS incidence declined for both sexes and in most of the regions of Brazil. Conclusions. Despite Brazil’s resource limitations and disparities in wealth between men and women and among the country’s regions, the introduction of universal access to HAART in Brazil has helped achieve impressive declines in AIDS mortality, and it may also be contributing to declines in AIDS incidence.Objetivo. Investigar las tendencias que han mostrado la mortalidad y la incidencia del sida en el Brasil durante el período de 1984 a 2000 y evaluar el efecto de la introducción en el país en 1996 de la terapia antirretrovírica de gran actividad (TAGA) accesible a toda la población. Métodos. Se usaron datos procedentes del sistema de notificación de enfermedades del Brasil y del sistema nacional de información sobre mortalidad para calcular las tasas de incidencia y de mortalidad por sida en cada región del país y según el sexo. También calculamos para cada región y según el sexo, las razones dadas por el número de muertes por sida en un año contra el número de casos de sida notificados dos años antes. Resultados. Las tasas de mortalidad en las cinco regiones del Brasil descendieron tanto en hombres como en mujeres después de adoptarse la TAGA, a pesar de que la incidencia de sida siguió aumentando. La razón del número de muertes por sida en un año al número de casos de sida notificados dos años antes llegó a emparejarse muy pronto en hombres y mujeres después de la introducción de la TAGA. En época más reciente, la incidencia de sida se ha reducido en ambos sexos en la mayoría de las regiones del Brasil. Conclusiones. A pesar de los limitados recursos que posee el Brasil y de las disparidades económicas observadas entre hombres y mujeres en las distintas regiones del país, la introducción de la TAGA accesible a toda la población ha ayudado a lograr un descenso muy notable de la mortalidad por sida y podría estar contribuyendo a reducir la incidencia de la enfermedadOswaldo Cruz Foundation. Centro de Informação Científica e Tecnológica. Rio de Janeiro, RJ, Brazil.Oswaldo Cruz Foundation. Centro de Informação Científica e Tecnológica. Rio de Janeiro, RJ, Brazil / University of California. School of Public Health. Department of Epidemiology. Berkeley, CA, United States of America.Oswaldo Cruz Foundation. Centro de Informação Científica e Tecnológica. Rio de Janeiro, RJ, Brazil / Stanford University. School of Medicine. Stanford, CA, United States of America.Oswaldo Cruz Foundation. Centro de Informação Científica e Tecnológica. Departamento de Informações em Saúde. Rio de Janeiro, RJ, Brasil.engOrganización Panamericana de la SaludAcquired immunodeficiency syndromeAntiretroviral therapyHighly activeHealth servicesMortalitySocioeconomic factorsBrazilHighly active antiretroviral therapy in Brazil: the challenge of universal access in a context of social inequalityLa terapia antirretrovírica de gran actividad en el Brasil: el reto del acceso para todos en un contexto de desigualdad socialinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZORIGINALBastos_Highly active antiretroviral_2004.pdfapplication/pdf89235https://www.arca.fiocruz.br/bitstream/icict/687/1/Bastos_Highly%20active%20antiretroviral_2004.pdfdccb60db01a4a7a50c354cc875db2f59MD51LICENSElicense.txttext/plain1841https://www.arca.fiocruz.br/bitstream/icict/687/2/license.txta30b6ce7b56af9dadf91dddff39caaafMD52TEXTBastos_Highly active antiretroviral_2004.pdf.txtBastos_Highly active antiretroviral_2004.pdf.txtExtracted texttext/plain24611https://www.arca.fiocruz.br/bitstream/icict/687/5/Bastos_Highly%20active%20antiretroviral_2004.pdf.txta07c95c0f8a9a062e41e3a38abf87474MD55THUMBNAILBastos_Highly active antiretroviral_2004.pdf.jpgBastos_Highly active antiretroviral_2004.pdf.jpgGenerated Thumbnailimage/jpeg2102https://www.arca.fiocruz.br/bitstream/icict/687/4/Bastos_Highly%20active%20antiretroviral_2004.pdf.jpgeed70978a2e632bd2bd90d28eb10db40MD54icict/6872023-08-23 13:25:09.892oai:www.arca.fiocruz.br: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Repositório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352023-08-23T16:25:09Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)false |
dc.title.en.fl_str_mv |
Highly active antiretroviral therapy in Brazil: the challenge of universal access in a context of social inequality |
dc.title.alternative.es.fl_str_mv |
La terapia antirretrovírica de gran actividad en el Brasil: el reto del acceso para todos en un contexto de desigualdad social |
title |
Highly active antiretroviral therapy in Brazil: the challenge of universal access in a context of social inequality |
spellingShingle |
Highly active antiretroviral therapy in Brazil: the challenge of universal access in a context of social inequality Vilas-Boas Hacker, Mariana de Andrea Acquired immunodeficiency syndrome Antiretroviral therapy Highly active Health services Mortality Socioeconomic factors Brazil |
title_short |
Highly active antiretroviral therapy in Brazil: the challenge of universal access in a context of social inequality |
title_full |
Highly active antiretroviral therapy in Brazil: the challenge of universal access in a context of social inequality |
title_fullStr |
Highly active antiretroviral therapy in Brazil: the challenge of universal access in a context of social inequality |
title_full_unstemmed |
Highly active antiretroviral therapy in Brazil: the challenge of universal access in a context of social inequality |
title_sort |
Highly active antiretroviral therapy in Brazil: the challenge of universal access in a context of social inequality |
author |
Vilas-Boas Hacker, Mariana de Andrea |
author_facet |
Vilas-Boas Hacker, Mariana de Andrea Petersen, Maya L. Enriquez, Melissa Bastos, Francisco Inácio Pinkusfeld Monteiro |
author_role |
author |
author2 |
Petersen, Maya L. Enriquez, Melissa Bastos, Francisco Inácio Pinkusfeld Monteiro |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Vilas-Boas Hacker, Mariana de Andrea Petersen, Maya L. Enriquez, Melissa Bastos, Francisco Inácio Pinkusfeld Monteiro |
dc.subject.por.fl_str_mv |
Acquired immunodeficiency syndrome Antiretroviral therapy Highly active Health services Mortality Socioeconomic factors Brazil |
topic |
Acquired immunodeficiency syndrome Antiretroviral therapy Highly active Health services Mortality Socioeconomic factors Brazil |
description |
Objective. To investigate trends in AIDS mortality and incidence in Brazil over the period of 1984 to 2000 and to assess the impact of the introduction of universal access to highly active antiretroviral therapy (HAART) in the country in 1996. Methods. Data from the Brazilian disease notification system and the national mortality information system were used to calculate annual region-specific and sex-specific AIDS incidence and mortality rates. We also calculated sex- and region-specific ratios of the number of AIDS deaths in one year to the number of AIDS cases notified two years earlier. Results. AIDS mortality rates for both men and women and in all five of the geographic regions of Brazil declined following introduction of HAART, despite continued growth in AIDS incidence. The ratio of the number of AIDS deaths in one year to the number of AIDS cases notified two years earlier for men equalized rapidly with the ratio for women following introduction of HAART. More recently, AIDS incidence declined for both sexes and in most of the regions of Brazil. Conclusions. Despite Brazil’s resource limitations and disparities in wealth between men and women and among the country’s regions, the introduction of universal access to HAART in Brazil has helped achieve impressive declines in AIDS mortality, and it may also be contributing to declines in AIDS incidence. |
publishDate |
2004 |
dc.date.issued.fl_str_mv |
2004 |
dc.date.accessioned.fl_str_mv |
2010-08-23T16:58:39Z 2010-11-04T14:19:43Z |
dc.date.available.fl_str_mv |
2010-08-23T16:58:39Z 2010-11-04T14:19:43Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
format |
article |
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publishedVersion |
dc.identifier.citation.fl_str_mv |
VILAS-BOAS Hacker, Mariana de Andrea et al. Highly active antiretroviral therapy in Brazil: the challenge of universal access in a context of social inequality. Revista Panamericana de Salud Pública / Pan American Journal of Public Health, Washington, v. 16, n. 2, p. 78-83, 2004. |
dc.identifier.uri.fl_str_mv |
https://www.arca.fiocruz.br/handle/icict/687 |
dc.identifier.issn.pt_BR.fl_str_mv |
1020-4989 |
identifier_str_mv |
VILAS-BOAS Hacker, Mariana de Andrea et al. Highly active antiretroviral therapy in Brazil: the challenge of universal access in a context of social inequality. Revista Panamericana de Salud Pública / Pan American Journal of Public Health, Washington, v. 16, n. 2, p. 78-83, 2004. 1020-4989 |
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https://www.arca.fiocruz.br/handle/icict/687 |
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eng |
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eng |
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Organización Panamericana de la Salud |
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Organización Panamericana de la Salud |
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