Background Colombia has the fourth highest incidence rate of HIV/AIDS among all Latin American countries and it has been increasing since the 1980s. However, the number of studies that addresses this trend is limited. Here, we employed spatial and temporal trend analyses to study the behaviour of the epidemic in the Colombian territory. Methods Our sample included 72,994 cases of HIV/AIDS and 21,898 AIDS-related deaths reported to the National Ministry of Health between 2008 and 2016. We employed the joinpoint regression model to analyse the annual HIV/AIDS incidence and AIDS mortality rates. In the spatial analysis, we used univariate autocorrelation techniques and the Kernel density estimator. Results While the HIV/AIDS incidence had an increasing trend in Colombia, the AIDS mortality rate was stable. HIV/AIDS incidence and AIDS mortality showed a downward trend in the 0–14 age group. An upward trend was observed for HIV/AIDS incidence in people older than 15 years and with the highest trend in the 65 years and above group. AIDS mortality showed an increasing trend among people aged 65 years or older. The comparison between the sexes showed an upward trend of HIV/AIDS incidence in all age groups and AIDS-mortality rates in 65 years and above in men, while in women, the incidence was upward among those aged 45 years and above, and concerning the AIDS-mortality rate in the 45–64 group. The high–high clusters of HIV/AIDS incidence and AIDS mortality were located in the Andean and Caribbean regions. Conclusion Our study found an upward trend in HIV/AIDS incidence and a stable trend in the AIDS mortality rate in Colombia. The downward trend in HIV/AIDS incidence and AIDS mortality rate in the 0–14 age group reflects the downwards mother-to-child HIV transmission. The upward trend in HIV/AIDS incidence in older women and AIDS mortality in younger women rates, compared with men, may be due to late diagnosis and treatment. The Caribbean and the ‘coffee belt’ regions were the most impacted by the HIV epidemic, most likely due to sexual tourism. Our results provide crucial information that may help Colombian health authorities fight HIV transmission.
BACKGROUND – Colombia has the fourth highest incidence rate of HIV/AIDS among all Latin American countries and it has been increasing since the 1980s. However, the number of studies that addressed this trend is limited. Here, we employed spatial and temporal trend analyses to study the behaviour of the epidemic in the Colombian territory.METHODS – Our sample included 72,994 cases of HIV/AIDS and 21,898 AIDS-related deaths reported to the National Ministry of Health between 2008 and 2016. We employed the joinpoint regression model to analyse the annual HIV/AIDS incidence and AIDS mortality rates. In the spatial analysis, we used univariate autocorrelation techniques and the Kernel density estimator. RESULTS – While the HIV/AIDS incidence had an increasing trend in Colombia, the AIDS mortality rate was stable. HIV/AIDS incidence and AIDS mortality showed a downward trend in the 0–14 age group. An upward trend was observed for HIV/AIDS incidence in people older than 15 years and with the highest trend in the 65 years and above group. AIDS mortality showed an increasing trend among people aged 65 years or older. The comparison between the sexes showed an upward trend of HIV/AIDS incidence in all age groups and AIDS-mortality rates in 65-year-old and above in men, while in women, the incidence was upward among those aged 45 years and above and concerning the AIDS-mortality rate in the 45–64 group. The high–high clusters of HIV/AIDS incidence and AIDS mortality were located in the Andean and Caribbean regions.CONCLUSION – Our study found an upward trend in HIV/AIDS incidence and a stable trend in the AIDS mortality rate in Colombia. The downward trend in HIV/AIDS incidence and AIDS mortality rate in the 0–14 age group reflects the downwards mother-to-child HIV transmission. The upward trend in HIV/AIDS incidence and AIDS mortality rates in older and younger women, respectively, compared with men may be due to late diagnosis and treatment. The Caribbean and the ‘coffee belt’ regions were the most impacted by the HIV epidemic, most likely due to sexual tourism. Our results provide crucial information that may help Colombian health authorities fight HIV.
Resumo Objetivo Analisar espaço-temporalmente a incidência do vírus da imunodeficiência humana (HIV) e da síndrome da imunodeficiência adquirida (Aids) entre idosos no estado do Pará, Brasil, nos anos de 2007 a 2018. Método Estudo ecológico utilizando notificações de casos de HIV/Aids em idosos provenientes do Sistema de Informação de Agravos de Notificação. A taxa de incidência do HIV/Aids foi analisada temporalmente pelo método de joinpoint e espacialmente pelas técnicas de autocorrelação de Moran, de varredura e de regressão espacial. Resultados 2.639 notificações de HIV/Aids foram elegíveis para o estudo, sendo 1.725 (65,4%) em homens e 914 (34,6%) em mulheres. No período do estudo houve aumento de 2.422,5% na taxa de incidência de HIV nos homens e de 1.929,8% nas mulheres, sendo o oposto, observado para a taxa de incidência de Aids que aumentou 77,6% nas mulheres e 40,7% nos homens. O método joinpoint revelou tendência crescente para a taxa de incidência de HIV (APC=30%, p=0,00) e de estabilidade para taxa de incidência de Aids (APC=3,0%, p=0,2). Os municípios mais impactados pela epidemia do HIV foram os do meridional sudeste paraense com moderada associação (R2=0,65) ao seu crescimento populacional. A análise de varredura espaço-temporal apontou Belém como zona de risco para o HIV/Aids (RR=3,93, p=0,00; 2017-2018) Conclusão Enquanto a incidência de Aids em idosos paraenses permaneceu estável no período de 2007 a 2018, a de HIV tendeu a crescer. O maior impacto da epidemia ocorreu nos municípios do sudeste paraense com associação ao crescimento populacional, e Belém apresentou risco espaço-temporal para o HIV/Aids.
Localizada na zona costeira do Pará, a RESEX Marinha de São João da Ponta foi criada para preservar importantes áreas de manguezais e garantir que as comunidades tradicionais de extrativistas que residem em sua Zona de Amortecimento (ZA) possam viver de forma sustentável. No que concerne a gestão desta Unidade de Conservação, a ZA tem a função de proteger os recursos ecossistêmicos, reduzindo a pressão das atividades humanas, principalmente ligadas ao crescimento da agricultura e da área urbana, formas de uso que ao longo do tempo vem contribuindo para a diminuição das áreas de vegetação, (floresta ombrófila densa aluvial e do manguezal). Neste trabalho, objetivou-se avaliar a dinâmica da paisagem na ZA, entre os períodos de 2010 e 2018. Foram utilizadas ferramentas de geoprocessamento na obtenção de informações espaciais referentes às mudanças na paisagem através da análise multitemporal de uso da terra e de métricas de paisagem. Constatou-se que no período analisado as maiores pressões sofridas na ZA estão relacionadas ao aumento das geoclasses agricultura e área urbana, relacionados com a melhoria da infraestrutura de transporte rodoviário e com o aumento da população no município.
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