INFLUENCE OF THE SOCIAL DETERMINANTS ON THE INCIDENCE OF AIDS IN PIAUÍ: AN ECOLOGICAL STUDY

Thatiana Araujo Maranhão,Maria Lúcia Duarte Pereira,Wilson Correia De Abreu,Carlos Henrique Alencar,George Jó Bezerra Sousa,Mônica De Avelar Figueiredo Mafra Magalhães

doi:10.1590/1980-265x-tce-2019-0235

Abstract

ABSTRACT Objective: to identify the social factors that determine the incidence of aids in the Piauí territory. Method: an ecological study that uses geoprocessing techniques in which 2,908 aids cases of individuals residing in Piauí were considered, notified to the Notifiable Disease Information System (Sistema de Informações de Agravos de Notificação, SINAN), from 2007 to 2015. Gross and Bayesian incidence rates were calculated using the population of the central year (2011), multiplied by 100,000 inhabitants, with Bayesian statistics used to identify spatial clusters. The non-spatial Ordinary Least Squares Estimation (OLS) and spatial Geographically Weighted Regression (GWR) regression models were used to identify the social determinants of the incidence of aids in the state, with 5% of significance. Results: the highest rates of the disease are concentrated in cities near the capital Teresina, with a Bayesian incidence of over 11.27 cases/100,000 inhabitants. The predictor variables of the incidence of ADIS in Piauí cities were the following: the percentage of individuals in houses with inadequate walls (p=0.0139), the mean number of residents per household (p=0.0309), and the percentage of individuals in households vulnerable to poverty and in which no one has completed elementary school (p=0.0051). Conclusion: according to GWR, the social factors that influence the incidence of aids in the cities of Piauí are the percentage of individuals in houses with inadequate walls, the mean number of residents per household, and the percentage of individuals in houses vulnerable to poverty and in which no one has completed elementary school. Given the above, interventions on the health social determinants of a structural nature should be established as effective methods for the prevention of HIV/ aids.

Highlights

Acquired Immunodeficiency Syndrome is a chronic disease that, despite more than 30 years of having been identified, still worries and challenges the world
This study aims to identify the social factors that determine the incidence of aids in the Piauian territory
All aids cases that occurred from 2007 to 2015 were investigated, in individuals living in the state, whose notification occurred through the Notifiable Diseases Notification System (SINAN)

Summary

Introduction

Acquired Immunodeficiency Syndrome (aids) is a chronic disease that, despite more than 30 years of having been identified, still worries and challenges the world. There are significant differences between the Brazilian regions since, as a decreasing tendency has been perceived in the Southern and Southwest regions of the country, in the Northern and Northeastern regions, a linear increase stands out in the detection rate of the disease in the last 10 years. In Piauí, a Northeastern Brazilian state, the aids detection rate had a mean increase of 45.6%, and the mortality coefficient rose 31.0% in the period from 2006 and 2016. Faced with the official statistics, the need for studies with a population nature that identify the factors that may be influencing the increase of the disease incidence in the state stands out.[3]

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