AIDS e infecção pelo HIV no Brasil: uma epidemia multifacetada

Abstract

The HIV/AIDS epidemic is a dynamic unstable global phenomenon, constituting a veritable mosaic of regional sub-epidemics. As a consequence of the deep inequalities that exist in Brazilian society, the spread of HIV infection has revealed an epidemic of multiple dimensions undergoing extensive epidemiological transformations. Initially restricted to large urban centers and markedly masculine, the HIV/AIDS epidemic is currently characterized by heterosexualization, feminization, interiorization and pauperization. The evolution of the profile of AIDS in Brazil is above all due to the geographical diffusion of the disease from large urban centers towards medium and small municipalities in the interior, to the increase in heterosexual transmission and the persistent growth of cases among injecting drug users. The increase in transmission through heterosexual contact has resulted in substantial growth of cases among women, which has been pointed out as the most important characteristic of the epidemic's current dynamic in Brazil.

Clinical and epidemiological analysis of patients with HIV/AIDS admitted to a reference hospital in the northeast region of Brazil

“…Injectable drug use (IDU) is not an important via of exposure in the North and Northeast regions of Brazil, a fact confirmed by only 17 registered cases in the IDTNP. Other authors have reported a high rate of IDU in the Southeast region, supplanting heterosexual exposure 3,11 .…”

“…Of the 828 patients investigated, 254 died (30.7%) and of these, 194 (76.4%) died during the initial attendance and 44 (17.3%) within the first 48 h of hospitalization. The average number of admittances per patient was 1.5 ± 1.4 (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). The number of infectious complications at death was of 2.1 ± 1.1 (0-8) and 231 (90.9%) patients presented up to three opportunistic infections at death.…”

“…The study was realized by a protocol based in the following items: date of the initial attendance at the IDTNP, gender, age, educational level, occupation, patient's city of residence, civil status, race, religion, probable mode of HIV acquisition, number of lymphocytes CD4/mm 3 , CD8/mm 3 and relation CD4/CD8 on the occasion of the initial attendance, type and number of the most frequent infections during clinical follow-up, number and duration of hospitalizations in the period studied, date of death and number of diagnosed infectious complications in the patients who died.…”

“…Currently, an epidemiological transition is taking place, characterized by the dissemination of HIV/AIDS in smaller urban centers and among women, people of heterosexual orientation and lower socioeconomic status 3,27 .…”

HIV infection and AIDS in a small municipality in Southeast Brazil

“…8,12,16 One study found a 4.1% annual increase in the incidence rate of male cases in the large cities of the Southeast macro-region between the years of 1990 and 1996; the corresponding figure for small southeastern municipalities was 20.8%. 16 Consequently, to appropriately design and implement adequate control measures, a better understanding of the characteristics of HIV infection in relatively small Brazilian communities and rural areas is urgently needed.…”