Reconstructing the AIDS epidemic among injection drug users in Brazil
Autor(a) principal: | |
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Data de Publicação: | 2006 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Cadernos de Saúde Pública |
Texto Completo: | https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/2740 |
Resumo: | The HIV/AIDS epidemic among injection drug users (IDUs) in Brazil has been unique in terms of temporal and geographical contrasts. This analysis explores these contrasts through the use of multilevel modeling. Standardized AIDS incidence rates among IDUs for Brazilian municipalities (1986-2000) were used as the dependent variable, with a set of social indicators as independent variables (covariates). In some States of the North/Northeast, the epidemic among IDUs has been incipient. The São Paulo epidemic extended to reach a network of municipalities, most of which located far from the capital. More recently, on a smaller scale, a similar extension has been observed in the southernmost States of the country. Both "number of physicians per inhabitant" and "standard distance to the State capital" were found to be associated with AIDS incidence. AIDS cases among IDUs appeared to cluster in wealthier, more developed municipalities. The relative weight of such extensive dissemination in key, heavily populated States prevails in the Brazilian IDU epidemic, defining a central-western-southeastern strip of wealthier middle-sized municipalities and more recently a southern strip of municipalities deeply affected by the epidemic in this population. |
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Reconstructing the AIDS epidemic among injection drug users in BrazilIntravenous Substance AbuseAcquired Immunodeficiency SyndromeResidence CharacteristicsIncidenceThe HIV/AIDS epidemic among injection drug users (IDUs) in Brazil has been unique in terms of temporal and geographical contrasts. This analysis explores these contrasts through the use of multilevel modeling. Standardized AIDS incidence rates among IDUs for Brazilian municipalities (1986-2000) were used as the dependent variable, with a set of social indicators as independent variables (covariates). In some States of the North/Northeast, the epidemic among IDUs has been incipient. The São Paulo epidemic extended to reach a network of municipalities, most of which located far from the capital. More recently, on a smaller scale, a similar extension has been observed in the southernmost States of the country. Both "number of physicians per inhabitant" and "standard distance to the State capital" were found to be associated with AIDS incidence. AIDS cases among IDUs appeared to cluster in wealthier, more developed municipalities. The relative weight of such extensive dissemination in key, heavily populated States prevails in the Brazilian IDU epidemic, defining a central-western-southeastern strip of wealthier middle-sized municipalities and more recently a southern strip of municipalities deeply affected by the epidemic in this population.A epidemia de HIV/AIDS entre usuários de drogas injetáveis (UDIs) apresenta, no Brasil, contrastes temporais e geográficos. Esta análise explora tais complexidades, com o emprego de modelagem multinível. As taxas padronizadas de incidência de AIDS em UDIs para os municípios brasileiros (período 1986-2000) foram consideradas como variável-dependente, e um conjunto de indicadores sociais como covariáveis. Em alguns Estados do Norte e Nordeste, a epidemia é incipiente entre UDIs, enquanto a epidemia paulista atinge uma rede de municípios, a maioria deles distantes da capital. Mais recentemente, e em menor escala, disseminação análoga foi observada nos Estados mais meridionais. As covariáveis "número de médicos por habitante" e "distância-padrão da capital do respectivo estado" se mostraram associadas à variável-dependente. Os casos de AIDS entre UDIs parecem se concentrar em municípios mais ricos e bem equipados. O peso relativo dessa disseminação extensa em Estados-chave, populosos, prevalece sobre o conjunto da epidemia brasileira, definindo uma faixa que se estende do Centro-oeste ao Sudeste, com municípios mais ricos, de médio porte, e, mais recentemente, uma faixa sul de municípios substancialmente afetados pela epidemia entre UDIs.Reports in Public HealthCadernos de Saúde Pública2006-04-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/2740Reports in Public Health; Vol. 22 No. 4 (2006): AprilCadernos de Saúde Pública; v. 22 n. 4 (2006): Abril1678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZenghttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/2740/5508https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/2740/5509Hacker, Mariana A.Leite, Iuri C.Renton, AdrianTorres, Tania Guillén deGracie, RenataBastos, Francisco I.info:eu-repo/semantics/openAccess2024-03-06T15:27:12Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/2740Revistahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csphttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/oaicadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2024-03-06T13:03:11.406214Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)true |
dc.title.none.fl_str_mv |
Reconstructing the AIDS epidemic among injection drug users in Brazil |
title |
Reconstructing the AIDS epidemic among injection drug users in Brazil |
spellingShingle |
Reconstructing the AIDS epidemic among injection drug users in Brazil Hacker, Mariana A. Intravenous Substance Abuse Acquired Immunodeficiency Syndrome Residence Characteristics Incidence |
title_short |
Reconstructing the AIDS epidemic among injection drug users in Brazil |
title_full |
Reconstructing the AIDS epidemic among injection drug users in Brazil |
title_fullStr |
Reconstructing the AIDS epidemic among injection drug users in Brazil |
title_full_unstemmed |
Reconstructing the AIDS epidemic among injection drug users in Brazil |
title_sort |
Reconstructing the AIDS epidemic among injection drug users in Brazil |
author |
Hacker, Mariana A. |
author_facet |
Hacker, Mariana A. Leite, Iuri C. Renton, Adrian Torres, Tania Guillén de Gracie, Renata Bastos, Francisco I. |
author_role |
author |
author2 |
Leite, Iuri C. Renton, Adrian Torres, Tania Guillén de Gracie, Renata Bastos, Francisco I. |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Hacker, Mariana A. Leite, Iuri C. Renton, Adrian Torres, Tania Guillén de Gracie, Renata Bastos, Francisco I. |
dc.subject.por.fl_str_mv |
Intravenous Substance Abuse Acquired Immunodeficiency Syndrome Residence Characteristics Incidence |
topic |
Intravenous Substance Abuse Acquired Immunodeficiency Syndrome Residence Characteristics Incidence |
description |
The HIV/AIDS epidemic among injection drug users (IDUs) in Brazil has been unique in terms of temporal and geographical contrasts. This analysis explores these contrasts through the use of multilevel modeling. Standardized AIDS incidence rates among IDUs for Brazilian municipalities (1986-2000) were used as the dependent variable, with a set of social indicators as independent variables (covariates). In some States of the North/Northeast, the epidemic among IDUs has been incipient. The São Paulo epidemic extended to reach a network of municipalities, most of which located far from the capital. More recently, on a smaller scale, a similar extension has been observed in the southernmost States of the country. Both "number of physicians per inhabitant" and "standard distance to the State capital" were found to be associated with AIDS incidence. AIDS cases among IDUs appeared to cluster in wealthier, more developed municipalities. The relative weight of such extensive dissemination in key, heavily populated States prevails in the Brazilian IDU epidemic, defining a central-western-southeastern strip of wealthier middle-sized municipalities and more recently a southern strip of municipalities deeply affected by the epidemic in this population. |
publishDate |
2006 |
dc.date.none.fl_str_mv |
2006-04-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/2740 |
url |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/2740 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/2740/5508 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/2740/5509 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html application/pdf |
dc.publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
dc.source.none.fl_str_mv |
Reports in Public Health; Vol. 22 No. 4 (2006): April Cadernos de Saúde Pública; v. 22 n. 4 (2006): Abril 1678-4464 0102-311X reponame:Cadernos de Saúde Pública instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ |
instname_str |
Fundação Oswaldo Cruz (FIOCRUZ) |
instacron_str |
FIOCRUZ |
institution |
FIOCRUZ |
reponame_str |
Cadernos de Saúde Pública |
collection |
Cadernos de Saúde Pública |
repository.name.fl_str_mv |
Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ) |
repository.mail.fl_str_mv |
cadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br |
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1798943356908208129 |