The role of socio-demographic determinants in the geo-spatial distribution of newly diagnosed HIV infections in small areas of Catalonia (Spain)

The complex link between socioeconomic deprivation and COVID-19. Evidence from small areas of Catalonia

This ecological study assesses the association between the incidence rate of COVID-19 confirmed cases and socioeconomic deprivation in the Catalan small areas for the first six waves of the pandemic. The association is estimated using Poisson regressions and, in contrast to previous studies, considering that the relationship is not linear but rather depends on the degree of deprivation. The results show that the association between deprivation and incidence varied between waves, not only in intensity but also in its sign. Although it was insignificant in the first, third and fourth waves, the association was positive and significant in the second, becoming significantly negative in the fifth and sixth waves. Interestingly, the evidence suggests that the link between both magnitudes was not homogeneous throughout the distribution of deprivation, the pattern also varying between waves. The results are discussed in view of the role of non-pharmacological interventions and vaccination, as well as potential biases (for example that associated with differences between population groups in the propensity to be tested in each wave).

Area-based comparison of risk factors and testing rates to improve sexual health care access: cross-sectional population-based study in a Dutch multicultural area

OBJECTIVES

Areas with high sexually transmitted infection (STI) testing rates may not require additional strategies to improve testing. However, it may be necessary to intervene in areas with elevated STI risk, but with low STI testing rates. We aimed to compare STI-related risk profiles and STI testing rates by geographical area to determine areas for improvement of sexual healthcare access.

DESIGN

Cross-sectional population-based study.

SETTING

Greater Rotterdam area, the Netherlands (2015-2019).

PARTICIPANTS

All residents aged 15-45 years. Individual population-based register data were matched with laboratory-based STI testing data of general practitioners (GPs) and the only sexual health centre (SHC).

OUTCOME MEASURES

Postal code (PC) area-specific STI risk scores (based on age, migratory background, education level and urbanisation), STI testing rates and STI positivity.

RESULTS

The study area consists of approximately 500 000 residents aged 15-45 years. Strong spatial variation in STI testing, STI positivity and STI risk was observed. PC area testing rate ranged from 5.2 to 114.9 tests per 1000 residents. Three PC clusters were identified based on STI risk and testing rate: (1) high-high; (2) high-low; (3) low, independently of testing rate. Clusters 1 and 2 had comparable STI-related risk and STI positivity, but the testing rate differed greatly (75.8 vs 33.2 per 1000 residents). Multivariable logistic regression analysis with generalised estimating equation was used to compare residents in cluster 1 and cluster 2. Compared with cluster 1, residents in cluster 2 more often did not have a migratory background, lived in less urbanised areas with higher median household income, and more distant from both GP and SHC.

CONCLUSION

The determinants associated with individuals living in areas with high STI-related risk scores and low testing rates provide leads for improvement of sexual healthcare access. Opportunities for further exploration include GP education, community-based testing and service (re)allocation.

Prevalence of the Human Immunodeficiency Virus and associated factors in pregnant women in the state of Pará

OBJECTIVES

to analyze the prevalence of the Human Immunodeficiency Virus and the associated factors in pregnant women in the state of Pará.

METHODS

retrospective, analytical, quantitative study with a sample of 332 medical records of HIV-positive pregnant women hospitalized at the Referral Maternity Hospital in the state of Pará between 2010 and 2019. Bivariate and multivariate statistical analysis were performed with the variables collected.

RESULTS

the average prevalence in the period was 2.39% and the Metropolitan Region concentrated 66.87% of cases. There was a strong relationship between the number of antenatal consultations and lack of knowledge of serological status (p value equal to 0.01E-17) variables, and a correlation between the education and number of antenatal consultations variables.

CONCLUSIONS

the increase in the infection rate during the study period revealed the need to intensify health actions, early diagnosis and strategies to improve adherence to antiretroviral treatment for maternal viral suppression and reduction of the risk of vertical transmission, contributing to improve public policies.

Prevalência do Vírus da Imunodeficiência Humana e fatores associados em gestantes no estado do Pará

RESUMO Objetivos: analisar a prevalência do Vírus da Imunodeficiência Humana e os fatores associados em gestantes no estado do Pará. Métodos: estudo analítico, quantitativo e retrospectivo com a amostra de 332 prontuários de gestantes HIV positivas internadas na Maternidade de Referência do estado do Pará, no período de 2010 a 2019. Com as variáveis coletadas, procedeu-se a análise estatística bivariada e multivariada. Resultados: a média de prevalência no período foi de 2,39% e a Região Metropolitana concentrou 66,87% dos casos. Houve forte relação entre as variáveis número de consultas pré-natais e desconhecimento do status sorológico (p valor igual a 0,01E-17) e correlação entre as variáveis escolaridade com o número de consultas pré-natais. Conclusões: o aumento da taxa de infecção no período estudado revelou a necessidade de intensificar as ações de saúde, o diagnóstico precoce e as estratégias para a melhoria da adesão ao tratamento antirretroviral para supressão viral materna e redução do risco de transmissão vertical, contribuindo para aprimorar as políticas públicas.