Differential Survival Benefit of Universal HAART Access in Brazil: A Nation-Wide Comparison of Injecting Drug Users Versus Men Who Have Sex With Men
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2009 |
| 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/1258 |
Resumo: | Oswaldo Cruz Foundation. Sergio Arouca School of Public Health. Social Science Department. Rio de Janeiro, RJ, Brazil. |
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Malta, Monica SiqueiraBastos, Francisco Inácio Pinkusfeld MonteiroSilva, Cosme Marcelo Furtado Passos daPereira, Gerson Fernando MendesLucena, Francisca de Fátima A.Medeiros, Maria Goretti Pereira FonsecaStrathdee, Steffanie Anne2010-11-04T17:52:55Z2010-11-04T17:52:55Z2009MALTA, Monica Siqueira et al. Differential Survival Benefit of Universal HAART Access in Brazil: A Nation-Wide Comparison of Injecting Drug Users Versus Men Who Have Sex With Men. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, v. 52, n. 5, p. 629-635, Dec. 15, 2009.1077-9450https://www.arca.fiocruz.br/handle/icict/125810.1097/QAI.0b013e3181b31b8aengLippincott Williams & Wilkins, Inc.Differential Survival Benefit of Universal HAART Access in Brazil: A Nation-Wide Comparison of Injecting Drug Users Versus Men Who Have Sex With Meninfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleOswaldo Cruz Foundation. Sergio Arouca School of Public Health. Social Science Department. Rio de Janeiro, RJ, Brazil.Oswaldo Cruz Foundation. Health Information Department, Center for Scientific and Technological Information. Rio de Janeiro, RJ, Brazil.Oswaldo Cruz Foundation. Sergio Arouca School of Public Health. Department of Epidemiology and Quantitative Methods. Rio de Janeiro, RJ, Brazil.Brazilian National STD/AIDS Program. Surveillance Unit. Brasilia, DF, Brazil.Brazilian National STD/AIDS Program. Surveillance Unit. Brasilia, DF, Brazil.Oswaldo Cruz Foundation. Evandro Chagas Clinical Research Institute. Rio de Janeiro, RJ, Brazil.University of California. School of Medicine. Department of Family and Preventive Medicine. Division of International Health and Cross Cultural Medicine. San Diego, CA, USA.Objective: Brazil accounts for ;70% of injection drug users (IDUs) receiving highly active antiretroviral therapy (HAART) in low-income/middle-income countries. We evaluated the impact of HAART availability/access on AIDS-related mortality among IDUs versus men who have sex with men (MSM). Design: Nation-wide analysis on Brazilian IDU and MSM diagnosed with AIDS in 2000–2006. Methods: Four national information systems were linked, and Cox regression was used to assess impact of HAART availability/access on differential AIDS-related mortality. Results: Among 28,426 patients, 6777 died during 87,792 personyears of follow-up. Compared with MSM, IDU were significantly less likely to be receiving HAART, to have ever had determinations for CD4 or viral load. After controlling for confounders, IDU had a significantly higher risk of death (adjusted hazard ratio: 1.94; 95% confidence interval: 1.84 to 2.05). Among the subset that had at least 1 CD4 and viral load determination, higher risk of death among IDU persisted (hazard ratio: 1.82; 95% confidence interval: 1.58 to 2.11). Nonwhite ethnicity significantly increased this risk, whereas prompt HAART uptake after AIDS diagnosis reduced the risk of death. After controlling for spatially correlated survival data, AIDS-related mortality remained higher in IDU than in MSM. Conclusions: Despite free/universal HAART access, differential AIDS-related mortality exists in Brazil. Efforts are needed to identify and eliminate these health disparities.AIDSDrug userHAARTHIVSurvivalinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZORIGINALBastos_Differential survival benefit.pdfBastos_Differential survival benefit.pdfapplication/pdf177119https://www.arca.fiocruz.br/bitstream/icict/1258/1/Bastos_Differential%20survival%20benefit.pdf6e6bfe43c836b315d57c922309c2161bMD51LICENSElicense.txtlicense.txttext/plain; charset=utf-81748https://www.arca.fiocruz.br/bitstream/icict/1258/2/license.txt8a4605be74aa9ea9d79846c1fba20a33MD52TEXTBastos_Differential survival benefit.pdf.txtBastos_Differential survival benefit.pdf.txtExtracted texttext/plain40269https://www.arca.fiocruz.br/bitstream/icict/1258/5/Bastos_Differential%20survival%20benefit.pdf.txtee987a4416898e5975e7698a842e48e8MD55THUMBNAILBastos_Differential survival benefit.pdf.jpgBastos_Differential survival benefit.pdf.jpgGenerated Thumbnailimage/jpeg2439https://www.arca.fiocruz.br/bitstream/icict/1258/4/Bastos_Differential%20survival%20benefit.pdf.jpg7513c50211cea598bbee07e385fd2605MD54icict/12582023-08-01 16:55:13.894oai:www.arca.fiocruz.br:icict/1258Tk9URTogUExBQ0UgWU9VUiBPV04gTElDRU5TRSBIRVJFClRoaXMgc2FtcGxlIGxpY2Vuc2UgaXMgcHJvdmlkZWQgZm9yIGluZm9ybWF0aW9uYWwgcHVycG9zZXMgb25seS4KCk5PTi1FWENMVVNJVkUgRElTVFJJQlVUSU9OIExJQ0VOU0UKCkJ5IHNpZ25pbmcgYW5kIHN1Ym1pdHRpbmcgdGhpcyBsaWNlbnNlLCB5b3UgKHRoZSBhdXRob3Iocykgb3IgY29weXJpZ2h0Cm93bmVyKSBncmFudHMgdG8gRFNwYWNlIFVuaXZlcnNpdHkgKERTVSkgdGhlIG5vbi1leGNsdXNpdmUgcmlnaHQgdG8gcmVwcm9kdWNlLAp0cmFuc2xhdGUgKGFzIGRlZmluZWQgYmVsb3cpLCBhbmQvb3IgZGlzdHJpYnV0ZSB5b3VyIHN1Ym1pc3Npb24gKGluY2x1ZGluZwp0aGUgYWJzdHJhY3QpIHdvcmxkd2lkZSBpbiBwcmludCBhbmQgZWxlY3Ryb25pYyBmb3JtYXQgYW5kIGluIGFueSBtZWRpdW0sCmluY2x1ZGluZyBidXQgbm90IGxpbWl0ZWQgdG8gYXVkaW8gb3IgdmlkZW8uCgpZb3UgYWdyZWUgdGhhdCBEU1UgbWF5LCB3aXRob3V0IGNoYW5naW5nIHRoZSBjb250ZW50LCB0cmFuc2xhdGUgdGhlCnN1Ym1pc3Npb24gdG8gYW55IG1lZGl1bSBvciBmb3JtYXQgZm9yIHRoZSBwdXJwb3NlIG9mIHByZXNlcnZhdGlvbi4KCllvdSBhbHNvIGFncmVlIHRoYXQgRFNVIG1heSBrZWVwIG1vcmUgdGhhbiBvbmUgY29weSBvZiB0aGlzIHN1Ym1pc3Npb24gZm9yCnB1cnBvc2VzIG9mIHNlY3VyaXR5LCBiYWNrLXVwIGFuZCBwcmVzZXJ2YXRpb24uCgpZb3UgcmVwcmVzZW50IHRoYXQgdGhlIHN1Ym1pc3Npb24gaXMgeW91ciBvcmlnaW5hbCB3b3JrLCBhbmQgdGhhdCB5b3UgaGF2ZQp0aGUgcmlnaHQgdG8gZ3JhbnQgdGhlIHJpZ2h0cyBjb250YWluZWQgaW4gdGhpcyBsaWNlbnNlLiBZb3UgYWxzbyByZXByZXNlbnQKdGhhdCB5b3VyIHN1Ym1pc3Npb24gZG9lcyBub3QsIHRvIHRoZSBiZXN0IG9mIHlvdXIga25vd2xlZGdlLCBpbmZyaW5nZSB1cG9uCmFueW9uZSdzIGNvcHlyaWdodC4KCklmIHRoZSBzdWJtaXNzaW9uIGNvbnRhaW5zIG1hdGVyaWFsIGZvciB3aGljaCB5b3UgZG8gbm90IGhvbGQgY29weXJpZ2h0LAp5b3UgcmVwcmVzZW50IHRoYXQgeW91IGhhdmUgb2J0YWluZWQgdGhlIHVucmVzdHJpY3RlZCBwZXJtaXNzaW9uIG9mIHRoZQpjb3B5cmlnaHQgb3duZXIgdG8gZ3JhbnQgRFNVIHRoZSByaWdodHMgcmVxdWlyZWQgYnkgdGhpcyBsaWNlbnNlLCBhbmQgdGhhdApzdWNoIHRoaXJkLXBhcnR5IG93bmVkIG1hdGVyaWFsIGlzIGNsZWFybHkgaWRlbnRpZmllZCBhbmQgYWNrbm93bGVkZ2VkCndpdGhpbiB0aGUgdGV4dCBvciBjb250ZW50IG9mIHRoZSBzdWJtaXNzaW9uLgoKSUYgVEhFIFNVQk1JU1NJT04gSVMgQkFTRUQgVVBPTiBXT1JLIFRIQVQgSEFTIEJFRU4gU1BPTlNPUkVEIE9SIFNVUFBPUlRFRApCWSBBTiBBR0VOQ1kgT1IgT1JHQU5JWkFUSU9OIE9USEVSIFRIQU4gRFNVLCBZT1UgUkVQUkVTRU5UIFRIQVQgWU9VIEhBVkUKRlVMRklMTEVEIEFOWSBSSUdIVCBPRiBSRVZJRVcgT1IgT1RIRVIgT0JMSUdBVElPTlMgUkVRVUlSRUQgQlkgU1VDSApDT05UUkFDVCBPUiBBR1JFRU1FTlQuCgpEU1Ugd2lsbCBjbGVhcmx5IGlkZW50aWZ5IHlvdXIgbmFtZShzKSBhcyB0aGUgYXV0aG9yKHMpIG9yIG93bmVyKHMpIG9mIHRoZQpzdWJtaXNzaW9uLCBhbmQgd2lsbCBub3QgbWFrZSBhbnkgYWx0ZXJhdGlvbiwgb3RoZXIgdGhhbiBhcyBhbGxvd2VkIGJ5IHRoaXMKbGljZW5zZSwgdG8geW91ciBzdWJtaXNzaW9uLgo=Repositório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352023-08-01T19:55:13Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)false |
| dc.title.pt_BR.fl_str_mv |
Differential Survival Benefit of Universal HAART Access in Brazil: A Nation-Wide Comparison of Injecting Drug Users Versus Men Who Have Sex With Men |
| title |
Differential Survival Benefit of Universal HAART Access in Brazil: A Nation-Wide Comparison of Injecting Drug Users Versus Men Who Have Sex With Men |
| spellingShingle |
Differential Survival Benefit of Universal HAART Access in Brazil: A Nation-Wide Comparison of Injecting Drug Users Versus Men Who Have Sex With Men Malta, Monica Siqueira AIDS Drug user HAART HIV Survival |
| title_short |
Differential Survival Benefit of Universal HAART Access in Brazil: A Nation-Wide Comparison of Injecting Drug Users Versus Men Who Have Sex With Men |
| title_full |
Differential Survival Benefit of Universal HAART Access in Brazil: A Nation-Wide Comparison of Injecting Drug Users Versus Men Who Have Sex With Men |
| title_fullStr |
Differential Survival Benefit of Universal HAART Access in Brazil: A Nation-Wide Comparison of Injecting Drug Users Versus Men Who Have Sex With Men |
| title_full_unstemmed |
Differential Survival Benefit of Universal HAART Access in Brazil: A Nation-Wide Comparison of Injecting Drug Users Versus Men Who Have Sex With Men |
| title_sort |
Differential Survival Benefit of Universal HAART Access in Brazil: A Nation-Wide Comparison of Injecting Drug Users Versus Men Who Have Sex With Men |
| author |
Malta, Monica Siqueira |
| author_facet |
Malta, Monica Siqueira Bastos, Francisco Inácio Pinkusfeld Monteiro Silva, Cosme Marcelo Furtado Passos da Pereira, Gerson Fernando Mendes Lucena, Francisca de Fátima A. Medeiros, Maria Goretti Pereira Fonseca Strathdee, Steffanie Anne |
| author_role |
author |
| author2 |
Bastos, Francisco Inácio Pinkusfeld Monteiro Silva, Cosme Marcelo Furtado Passos da Pereira, Gerson Fernando Mendes Lucena, Francisca de Fátima A. Medeiros, Maria Goretti Pereira Fonseca Strathdee, Steffanie Anne |
| author2_role |
author author author author author author |
| dc.contributor.author.fl_str_mv |
Malta, Monica Siqueira Bastos, Francisco Inácio Pinkusfeld Monteiro Silva, Cosme Marcelo Furtado Passos da Pereira, Gerson Fernando Mendes Lucena, Francisca de Fátima A. Medeiros, Maria Goretti Pereira Fonseca Strathdee, Steffanie Anne |
| dc.subject.en.pt_BR.fl_str_mv |
AIDS Drug user HAART HIV Survival |
| topic |
AIDS Drug user HAART HIV Survival |
| description |
Oswaldo Cruz Foundation. Sergio Arouca School of Public Health. Social Science Department. Rio de Janeiro, RJ, Brazil. |
| publishDate |
2009 |
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2009 |
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2010-11-04T17:52:55Z |
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2010-11-04T17:52:55Z |
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MALTA, Monica Siqueira et al. Differential Survival Benefit of Universal HAART Access in Brazil: A Nation-Wide Comparison of Injecting Drug Users Versus Men Who Have Sex With Men. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, v. 52, n. 5, p. 629-635, Dec. 15, 2009. |
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https://www.arca.fiocruz.br/handle/icict/1258 |
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1077-9450 |
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10.1097/QAI.0b013e3181b31b8a |
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MALTA, Monica Siqueira et al. Differential Survival Benefit of Universal HAART Access in Brazil: A Nation-Wide Comparison of Injecting Drug Users Versus Men Who Have Sex With Men. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, v. 52, n. 5, p. 629-635, Dec. 15, 2009. 1077-9450 10.1097/QAI.0b013e3181b31b8a |
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Lippincott Williams & Wilkins, Inc. |
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Lippincott Williams & Wilkins, Inc. |
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