FATORES ASSOCIADOS À AIDS EM JOVENS E IDOSOS BRASILEIROS

Abstract

This study aimed to estimate the incidence rates of AIDS among young and old people in Brazilian states, describe the sociodemographic characterization and analyze its association with contextual factors. This is a quantitative, ecological, analytical study, based on secondary data from the Notifiable Diseases Information System - SINAN- (n = 116,393); AIDS incidence rates were related to individual and contextual variables in the 2007-2017 time series. Of the 116,393 cases filtered according to the variables of interest, 86,247 corresponded to young people and 30,146 elderly people. The individual data analyzed were: sex, race / color, education, federative unit of residence, probable mode of transmission and category of exposure. It was found that in relation to individual variables, the occurrence of AIDS is more frequent in men, both in the group of young people and in the elderly, with a predominance of white race for both, being the most frequent category of exposure for young people to homosexual and for the elderly, heterosexual. The average annual rate of AIDS incidence in Brazil for every 100 thousand inhabitants was 21,126 for young people and 12,877 for the elderly. The Brazilian region with the highest annual AIDS incidence rate was the South region for the elderly and the North region for young people. The related contextual determinants were the Gini coefficient, the Human Development Index (HDI) and the population coverage of Family Health Strategy (FHS) teams. The analysis of the association between AIDS incidence rates among young people and the elderly and each contextual variable was analyzed statistically and the data submitted to Poisson regression, with robust variance. Results with p <0.05 were considered statistically significant. As for the contextual aspects, it was found that the incidence of AIDS was inversely proportional to the FHS coverage in the states with the lowest HDI, regardless of the effect of income distribution (analysis adjusted by the Gini index). As for the elderly, in the regions with the lowest HDI, this group repeats the pattern found in young people in the regions with the highest HDI. The incidence of AIDS was inversely associated with USF coverage, with a higher rate of AIDS incidence in regions with higher income concentration. It was concluded that the AIDS incidence rate in Brazil is high, with an increasing trend among men from both the youth and the elderly group, which may be related to the social inequities that interfere in the health-disease process. With regard to contextual factors, there is an influence of FHS coverage on the AIDS incidence rate in young people in the most economically disadvantaged capitals, with the Gini index not being prevalent in any age group, although these are not specific isolated factors related to the disease , because it affects more and less vulnerable individuals in the Brazilian territory, even if with different intensities. It is noticed that the coverage of FHS teams in the most vulnerable regions allows for a more specific action, given the bond established between the user and the professionals of the unit to which he is inserted, being offered both curative care and the possibility of participation. in health promotion and sexually transmitted infection prevention groups, which could be preventable. Primary health care, as the ordering of care and for the integrality of its performance, needs to assume this role of welcoming, counseling and treatment of the initial stages of the AIDS disease and also working in a coordinated way to the specialized STI / AIDS centers, positively impacting the care to the user. Keywords: Socioeconomic factors. AIDS. Young. Seniors. Family Health Strategy. Coverage of Public Health Services.