Abstract

Over 30 years after the acquired immunodeficiency syndrome epidemic, several strategies have been implemented to verify the trend of the infection, the profile of the affected individuals, and the impact of prevention and control measures, with notification of asymptomatic carriers being the most recent measure. This study aimed to verify the geographic distribution of human immunodeficiency virus/acquired immunodeficiency syndrome and analyze the association between case definition criteria, sociodemographic data, and clinical aspects of the disease in the State of Minas Gerais between 2007 and 2016. In this ecological and analytical study, 35,349 cases of human immunodeficiency virus/acquired immunodeficiency syndrome reported in the State of Minas Gerais between 2007 and 2016 were analyzed. The data were analyzed using multiple correspondence factor analysis, time series analysis, descriptive statistics, and spatial distribution of the cases by macro-region. The majority of the patients were brown-skinned individuals, alive, diagnosed with human immunodeficiency virus/acquired immunodeficiency syndrome on the basis of the criteria adapted from the Centers for Disease Control and Prevention, and living in municipalities with more than 50,000 (80.5%) inhabitants. Between 2007 and 2016, there was an increase in the number of criteria used for diagnosing human immunodeficiency virus. By contrast, a consequent decrease was observed in the number of criteria used for defining cases, which were adapted from the Centers for Disease Control and Prevention, Rio de Janeiro/Caracas, and for identifying AIDS-related deaths. Young people aged between 13 and 29 years, individuals whose education level is compatible with the observed age, and homosexual men were associated with the HIV+ criterion. Out study showed that after the mandatory notification of human immunodeficiency virus-positive cases in 2014, there was a decrease in other criteria for defining human immunodeficiency virus/acquired immunodeficiency syndrome cases and changes in the profile of people living with human immunodeficiency virus/acquired immunodeficiency syndrome.

Highlights

  • Over 30 years after the acquired immunodeficiency syndrome epidemic, several strategies have been implemented to verify the trend of the infection, the profile of the affected individuals, and the impact of prevention and control measures, with notification of asymptomatic carriers being the most recent measure

  • After the mandatory notification of HIV-positive cases, there was an increase in the temporal trend of this case criterion to the detriment of the others and the association of this criterion with the diagnosis of HIV in white individuals, in individuals aged up to 29 years, male homosexuals, and those with education level compatible with the observed age

  • A study conducted in Recife and Curitiba in 2013 had already verified a high incidence of HIV in men who have sex with men (MSM) and stressed the importance and urgency of strategies to control the spread of the epidemic in this population subgroup[15]

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Summary

Introduction

Over 30 years after the acquired immunodeficiency syndrome epidemic, several strategies have been implemented to verify the trend of the infection, the profile of the affected individuals, and the impact of prevention and control measures, with notification of asymptomatic carriers being the most recent measure. This study aimed to verify the geographic distribution of human immunodeficiency virus/acquired immunodeficiency syndrome and analyze the association between case definition criteria, sociodemographic data, and clinical aspects of the disease in the State of Minas Gerais between 2007 and 2016. A consequent decrease was observed in the number of criteria used for defining cases, which were adapted from the Centers for Disease Control and Prevention, Rio de Janeiro/Caracas, and for identifying AIDS-related deaths. Clinical monitoring of people living with human immunodeficiency virus/acquired immunodeficiency syndrome (PLHA), defined by the Pan American Health Organization, was carried out in three stages/goals These goals became known as 90-90-90, in which countries by 2020 should reach 90% of the diagnosed PLHA, 90% of PLHA under antiretroviral therapy (ART), and 90% of PLHA under ART with viral suppression[3,4,5,6]

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