Santos NS, Tayra A, Silva SR, Buchalla C, Laurenti R. AIDS in the State ofSão Paul Changes in the epidemics profile and the perspectives of epidemiological surveillance. Brazilian Journal of Epidemiology 2002 December; 5(3):286-310.
Objectives:To analyze data from the System of Epidemiological Surveillance of sexually transmitted diseases/ AIDS in the State of São Paulo in order to discover the epidemics profile and changes in the epidemiological pattern.
Methodology:Quantitative analysis of secondary data.
Results: Although initially linked to men who have sex with men, particularly in the developed countries and in Latin America, HIV rapidly has disseminated among diverse segments, reaching women, men with heterosexual practices, and children. The magnitude of AIDS reflects the increasing inequality between developed and developing countries. Accentuating differences in access to treatment, mortality decreases in the rich countries and increases in the poorest countries. Brazil is an exception because it is one of the few countries that adopted the policy of free distribution of antiretroviral medications. In that country, mortality decreased markedly after 1996, and the use of antiretroviral medications is one of the most important factors. The data analyzed indicate that currently deaths in Brazil occur in the most advanced age groups. The epidemic appears in all social strata, but an increase is observed in the number of cases among persons of less schooling and less qualified occupations. Thus, an increase in the number of cases among heterosexual men is confirmed, together with a large predominance of this form of transmission in the feminine population, which corroborates the hypothesis of the heterosexualization of the epidemic. The traditional System of Epidemiological Surveillance in Brazil, in the case of AIDS, has been improved with the addition of other strategies that permit early detection of cases, with the objective of obtaining information closer to the moment of infection.
Conclusions: Free access to antiretroviral medications in Brazil has demonstrated an impact in reducing mortality from AIDS. This country also presents an example of the importance of improving the opportunity for and rapidity of data collection and analysis, for programming prevention.
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