Hacker Mariana A, Leite Iuri C, Renton Adrian, Torres Tania Guillén de, Gracie Renata, Bastos Francisco I
Centro de Informação Científica e Tecnológica, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
Cad Saude Publica. 2006 Apr;22(4):751-60. doi: 10.1590/s0102-311x2006000400014. Epub 2006 Apr 5.
The HIV/AIDS epidemic among injection drug users (IDUs) in Brazil has been unique in terms of temporal and geographical contrasts. This analysis explores these contrasts through the use of multilevel modeling. Standardized AIDS incidence rates among IDUs for Brazilian municipalities (1986-2000) were used as the dependent variable, with a set of social indicators as independent variables (covariates). In some States of the North/Northeast, the epidemic among IDUs has been incipient. The São Paulo epidemic extended to reach a network of municipalities, most of which located far from the capital. More recently, on a smaller scale, a similar extension has been observed in the southernmost States of the country. Both "number of physicians per inhabitant" and "standard distance to the State capital" were found to be associated with AIDS incidence. AIDS cases among IDUs appeared to cluster in wealthier, more developed municipalities. The relative weight of such extensive dissemination in key, heavily populated States prevails in the Brazilian IDU epidemic, defining a central-western-southeastern strip of wealthier middle-sized municipalities and more recently a southern strip of municipalities deeply affected by the epidemic in this population.
巴西注射吸毒者中的艾滋病毒/艾滋病疫情在时间和地理对比方面独具特色。本分析通过使用多层次模型来探究这些对比。巴西各市镇注射吸毒者的标准化艾滋病发病率（1986 - 2000年）被用作因变量，一组社会指标作为自变量（协变量）。在北部/东北部的一些州，注射吸毒者中的疫情尚处于初期。圣保罗的疫情蔓延至一个市镇网络，其中大多数市镇距离首府较远。最近，在该国最南端的几个州，也观察到了规模较小的类似蔓延情况。研究发现，“每居民医生数量”和“到州首府的标准距离”均与艾滋病发病率相关。注射吸毒者中的艾滋病病例似乎集中在较富裕、较发达的市镇。这种广泛传播在主要人口密集州的相对权重在巴西注射吸毒者疫情中占主导地位，形成了一条中西部 - 东南部的较富裕中型市镇地带，以及最近一条受该人群疫情严重影响的南部市镇地带。
