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[巴西1989 - 1997年艾滋病流行的社会人口学分析]

[A sociodemographic analysis of the AIDS epidemic in Brazil, 1989-1997].

作者信息

Fonseca Maria Goretti Pereira, Szwarcwald Célia Landmann, Bastos Francisco Inácio

机构信息

Coordenação Nacional de Doenças Sexualmente Transmissíveis (DST) e Aids, Ministério da Saúde, Brasília, DF, Brasil.

出版信息

Rev Saude Publica. 2002 Dec;36(6):678-85. doi: 10.1590/s0034-89102002000700004.

Abstract

OBJECTIVE

To describe the temporal evolution of AIDS epidemic analyzed from a socio-demographic and behavioral perspective and focusing on the individual's educational level.

METHODS

All AIDS cases aged 20 to 69, diagnosed with more than 7 days of difference between the dates of death and of diagnosis and reported to the Ministry of Health's Case Report Data Center from 1989 to 1997 were analyzed. Three educational levels were considered: "level I" (less or equivalent to 8 years of schooling), "level II" (more than 8 years of schooling) and "unknown" (no available information). A descriptive analysis of the temporal evolution of the distribution of AIDS cases during the study period was carried out for both sexes and categorized by educational levels, geographic region, county population size, and exposure categories. Multivariate logistic analysis was performed to assess the variables combined effect.

RESULTS

Information on educational level was not available in 22% of the cases. Where there was available information, higher percentages of "level I" were observed among females, in the southeast and south regions, municipalities with less than 500,000 inhabitants, and in the "heterosexual" and "IDU" exposure categories. For all variables analyzed, it was observed a gradual reduction on the percentages of cases with a higher level of education, in the time period analyzed, for both sexes, less intense among the cases in "homosexual or bisexual" exposure category.

CONCLUSIONS

The AIDS epidemic in Brazil started in social strata of higher educational level, spreading to populations with low educational level, especially among females, as well as to smaller population counties, through heterosexual contacts and use of injecting drugs.

摘要

目的

从社会人口统计学和行为学角度描述艾滋病疫情的时间演变,并重点关注个人教育水平。

方法

分析了1989年至1997年期间诊断的所有年龄在20至69岁之间、死亡日期与诊断日期相差7天以上且报告给卫生部病例报告数据中心的艾滋病病例。考虑了三个教育水平:“一级”(受教育年限少于或等于8年)、“二级”(受教育年限超过8年)和“未知”(无可用信息)。对研究期间艾滋病病例分布的时间演变进行了描述性分析,按性别、教育水平、地理区域、县人口规模和暴露类别进行分类。进行多变量逻辑分析以评估变量的综合效应。

结果

22%的病例没有教育水平信息。在有可用信息的情况下,女性、东南部和南部地区、居民少于50万的城市以及“异性恋”和“注射吸毒者”暴露类别中,“一级”的比例较高。对于所有分析的变量,在分析的时间段内,观察到教育水平较高的病例百分比逐渐下降,在“同性恋或双性恋”暴露类别的病例中下降幅度较小。

结论

巴西的艾滋病疫情始于高教育水平的社会阶层,通过异性接触和注射吸毒传播到低教育水平人群,尤其是女性,以及较小人口规模的县。

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