Hacker Mariana A, Leite Iuri, Friedman Samuel R, Carrijo Renata Gracie, Bastos Francisco I
Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Avenida Brasil, 4365, Zip code 21040-360 Rio de Janeiro, Brazil.
National School of Public Health, Oswaldo Cruz Foundation, Avenida Brasil, 4365, Zip code 21040-360 Rio de Janeiro, Brazil.
Health Place. 2009 Jun;15(2):514-519. doi: 10.1016/j.healthplace.2008.09.011. Epub 2008 Nov 6.
The aim of this paper is to study how structural determinants and the role of injecting drug users (IDUs) as a bridging population to the general population affected the AIDS subepidemic in southern Brazil during 1986-2000. Data from 288 southernmost Brazilian municipalities were analyzed. Using hierarchical modeling and inputs from a Geographic Information System, a multilevel model was constructed. The dependent variable was the logged AIDS standardized incidence rate (among the heterosexual population aged 15-69-years-old); independent variables included indicators for education, water provision, sewage, and garbage collection, per capita income, Gini coefficient (on income), Human Development Index, indicators of accessibility, and AIDS rate among IDUs. Significant predictors included AIDS rate among IDUs, distance from/to highways/railways, the Human Development Index and the ratio of residents who have access to sanitary installations. Poverty (as measured by socioeconomic indicators) and bridging from IDUs contribute to the spread of HIV/AIDS in Brazilian southern municipalities.
本文旨在研究结构决定因素以及注射吸毒者作为连接普通人群的桥梁群体在1986年至2000年期间如何影响巴西南部的艾滋病亚流行情况。分析了巴西南部最南端288个市的数据。利用分层建模和地理信息系统的输入，构建了一个多层次模型。因变量是艾滋病标准化发病率的对数（15至69岁异性恋人群中）；自变量包括教育、供水、污水和垃圾收集指标、人均收入、基尼系数（收入方面）、人类发展指数、可达性指标以及注射吸毒者中的艾滋病发病率。重要预测因素包括注射吸毒者中的艾滋病发病率、与高速公路/铁路的距离、人类发展指数以及能够使用卫生设施的居民比例。贫困（由社会经济指标衡量）以及注射吸毒者的桥梁作用促使艾滋病毒/艾滋病在巴西南部各市传播。
