Políticas públicas de saúde face à epidemia da AIDS e a assistência às pessoas com a doença

Case-control study on challenges in loss of follow-up care and the limitations in the reach of HIV policies for women

INTRODUCTION

HIV has transitioned from a devastating 1980s epidemic to a manageable chronic condition with antiretroviral therapy. In Brazil, challenges persist, including high detection rates and loss of medical follow-up among people living with HIV/AIDS (PLHIV). Adherence, engagement, and avoiding loss to follow-up are critical for effective HIV/AIDS prevention and care.

OBJECTIVES

This case-control study within longitudinal research on PLHIV linkage and retention in Porto Alegre aims to analyze factors associated with treatment abandonment.

METHODS

The study, based on patients from the Therapeutic Care Service for HIV and AIDS at Sanatorio Partenon Hospital, involved 360 PLHIV in a retention and linkage outpatient clinic.

RESULTS

Risk factors for loss to follow-up include cisgender women, diagnosis between 1991 and 2005, and non-adherence to antiretroviral treatment (ART). Conversely, cisgender men, diagnosis between 2015 and 2023, and good ART adherence were protective factors.

CONCLUSION

Gender disparities and ART non-adherence pose significant challenges in comprehensive PLHIV care. Cisgender women diagnosed before 2005 face higher risk, while cisgender men diagnosed after 2015 with good ART adherence are more protected, influencing care and prevention strategies for PLHIV.

The burden of AIDS: a time series analysis of thirty-five years of the epidemic in Brazil

Although traditional epidemiological information, such as mortality rate and prevalence or incidence rates, is relevant to the understanding of AIDS epidemiology in Brazil, a more complete indicator would be recommended. The aim of this study was to estimate the burden of AIDS and its trends in Brazil from 1980 to 2015. An ecological study using secondary data on mortality, morbidity and demography was carried out. Data were collected from official health information sources. Disability-adjusted life years (DALY) index was estimated by year. Trend analysis of the rates were performed using a segmented linear regression method. There were 826,452 confirmed HIV/AIDS cases and 302,614 deaths from AIDS-related causes in the studied period. The greatest burden occurred between 1994 and 1996, with a significant increase in the burden of AIDS for both sexes. The burden of AIDS in Brazil remains high, with a tendency to increase significantly the DALY rates in the study period. However, trend reversals in the DALY rates and in the mortality component, with a consequent increase in the morbidity component, were identified from 1995 onwards.

[AIDS in children: the influence of socioeconomic differences in Fortaleza, Ceará State, Brazil]

This study aimed to analyze the relationship between pediatric AIDS cases and neighborhood socioeconomic characteristics in Fortaleza, Ceará State, Brazil. This was an ecological and descriptive study with socioeconomic data from the 2010 Population Census and AIDS data in children for 2001-2011 from the Information System on Notifiable Diseases. Pearson's correlation was performed and the Moran index was used to verify spatial autocorrelation. A multinomial model was used to identify clusters. Of the total sample, 57.8% were male. In 18.8% of the children, the diagnosis was made after two years of age. There was a positive spatial correlation between AIDS cases in children and income (I = 0.6; p = 0.001) and the proportion of poor (I = 0.5; p = 0.001). Neighborhoods with these characteristics are mainly located in the Northwest and Southwest areas of the city. Spatial correlation between pediatric AIDS cases and socioeconomic indicators highlights the need for interventions aimed at improving health and living conditions.

Política de saúde no Brasil: produção científica 1988-2014

O objetivo deste trabalho é mapear a produção científica em política de saúde no Brasil, na base SciELO, no período 1988-2014. Foram identificados 769 artigos, classificados em três grupos: a) análises políticas em saúde (10,2%) com predominância de estudos que analisam a reforma sanitária brasileira; b) estudos sobre financiamento, gestão, organização e infraestrutura do sistema de saúde (28,8%); c) estudos sobre análises de políticas de saúde específicas (49%). Constatou-se aumento da quantidade de publicações ao longo do tempo e concentração de estudos no último grupo, evidenciando a progressiva substituição de análises do processo político mais geral por estudos de políticas específicas.

Perception of health professionals about the prevention of the AIDS epidemic in Florianópolis, Santa Catarina, Brazil (1986-2006)

Socio-historical research whose aim was to know the perception of health professionals about AIDS epidemic prevention from 1986 to 2006. They worked in a reference hospital for infectious and contagious diseases. The data was collected from March to October 2011, using the oral story technique, and the subjects were twenty-three health professionals who looked after people suffering from Acquired Immune Deficiency Syndrome during the above mentioned period. The content analysis described by Bardin was used and two categories came up: the need for preventive strategies and the lack of using condoms. The results showed that the health professionals' perception about AIDS prevention was bad due to: the media fragility, the health professionals' actions regarding preventive strategies and the trivialization of the preventive measures by the society, by not using condoms in sexual intercourse. We concluded that ignoring the disease led to slowing down the process of clarifying and preventing HIV/AIDS.