Universidade Nove de Julho. Faculdade de Medicina. Diretoria de Ciências Médicas. São Paulo, SP, Brasil.
Universidade de São Paulo. Faculdade de Saúde Pública. Departamento de Epidemiologia. São Paulo, SP, Brasil.
Rev Saude Publica. 2020 Nov 9;54:96. doi: 10.11606/s1518-8787.2020054001815. eCollection 2020.
To identify spatial and space-time clusters with high incidence rates of AIDS in men living in the city of São Paulo since the first case of the disease in 1980.
HIV/AIDS notifications were obtained from the Notifiable Diseases Information System (57,440 men) between January 1980 and June 2012. The cases were geocoded by residence address; then analyses of purely spatial, space-time and spatial variation in temporal trends were performed for three sets of data: total cases of AIDS in men aged 13 years or older, men aged 50 years or older, and deaths from AIDS.
It was possible to geocode a significant proportion of AIDS cases (93.7%). In the purely spatial scanning analysis, considering the entire period evaluated, the AIDS epidemic in men presented an important spatial concentration in the Center and in contiguous areas of the North, Southeast and West regions of the municipality, regardless of age group and evolution to death (relative risks between 1.22 and 5.90). Considering space and time simultaneously, several clusters were found, spread throughout all regions of the municipality (relative risks between 1.44 and 8.61). In the analysis of spatial variation in temporal trends, the clusters in the most peripheral regions presented a higher annual percentage increase in disease rates (up to 7.58%), denoting the tendency of "peripherization" of the epidemic in men in the city of São Paulo.
This study allowed the detection of geographic clusters of high risk for AIDS in men, pointing to priority areas in the municipality, both for programmatic actions and to guide other studies.
自 1980 年首例艾滋病病例以来,确定居住在圣保罗市的男性艾滋病发病率较高的空间和时空聚集区。
从 1980 年 1 月至 2012 年 6 月,从法定传染病信息系统中获取艾滋病病毒/艾滋病通知(57440 名男性)。根据居住地址对病例进行地理编码;然后对三组数据进行纯粹的空间、时空和时空趋势的空间变异性分析:13 岁及以上男性的艾滋病总病例数、50 岁及以上男性的艾滋病病例数和艾滋病死亡数。
能够对很大一部分艾滋病病例进行地理编码(93.7%)。在纯粹的空间扫描分析中,考虑到评估的整个时期,男性艾滋病流行呈现出重要的空间集中在中心和北部、东南部和西部地区的连续地区,无论年龄组和向死亡的演变(相对风险在 1.22 到 5.90 之间)。同时考虑空间和时间,发现了几个集群,分布在该市所有地区(相对风险在 1.44 到 8.61 之间)。在时空趋势的空间变异性分析中,最偏远地区的集群呈现出更高的疾病发病率年增长率(高达 7.58%),这表明艾滋病在圣保罗市男性中的流行趋势向“边缘化”发展。
本研究发现了男性艾滋病高危地理集群,指出了该市的优先领域,无论是针对方案行动还是指导其他研究。