Universidade de São Paulo. Faculdade de Medicina. Departamento de Medicina Preventiva. São Paulo, SP, Brasil.
Universidade de São Paulo. Faculdade de Medicina. Departamento de Pediatria. São Paulo, SP, Brasil.
Rev Saude Publica. 2023 Apr 17;57:26. doi: 10.11606/s1518-8787.2023057004476. eCollection 2023.
To estimate the public-private composition of HIV care in Brazil and the organizational profile of the extensive network of public healthcare facilities.
Data from the Qualiaids-BR Cohort were used, which gathers data from national systems of clinical and laboratory information on people aged 15 years or older with the first dispensation of antiretroviral therapy between 2015-2018, and information from SUS healthcare facilities for clinical-laboratory follow-up of HIV, produced by the Qualiaids survey. The follow-up system was defined by the number of viral load tests requested by any SUS healthcare facility: follow-up in the private system - no record; follow-up at SUS - two or more records; undefined follow-up - one record. SUS healthcare facilities were characterized as outpatient clinics, primary care and prison system, according to the respondents' self-classification in the Qualiaids survey (72.9%); for non-respondents (27.1%) the classification was based on the terms present in the names of the healthcare facilities.
During the period, 238,599 people aged 15 years or older started antiretroviral therapy in Brazil, of which 69% were followed-up at SUS, 21.7% in the private system and 9.3% had an undefined system. Among those followed-up at SUS, 93.4% received care in outpatient clinics, 5% in primary care facilities and 1% in the prison system.
In Brazil, antiretroviral treatment is provided exclusively by SUS, which is also responsible for clinical and laboratory follow-up for most people in outpatient clinics. The study was only possible because SUS maintains records and public information about HIV care. There is no data available for the private system.
估计巴西艾滋病毒护理的公私构成以及广泛的公共医疗保健设施网络的组织概况。
使用 Qualiaids-BR 队列的数据，该队列收集了 2015-2018 年间年龄在 15 岁及以上的首次接受抗逆转录病毒治疗的人群的国家临床和实验室信息系统数据，以及来自 SUS 艾滋病毒临床实验室随访的信息，由 Qualiaids 调查提供。随访系统是根据任何 SUS 医疗保健机构要求的病毒载量检测数量来定义的：私人系统随访-无记录；SUS 随访-两次或更多记录；未定义随访-一次记录。根据受访者在 Qualiaids 调查中的自我分类（72.9%），将 SUS 医疗保健机构分为门诊、初级保健和监狱系统；对于未回答者（27.1%），分类基于医疗保健机构名称中的术语。
在此期间，巴西有 238599 名 15 岁及以上的人开始接受抗逆转录病毒治疗，其中 69%在 SUS 接受随访，21.7%在私人系统，9.3%系统未定义。在接受 SUS 随访的人群中，93.4%在门诊接受治疗，5%在初级保健机构，1%在监狱系统。
在巴西，抗逆转录病毒治疗完全由 SUS 提供，SUS 还负责为大多数门诊患者提供临床和实验室随访。这项研究之所以成为可能，是因为 SUS 保存了艾滋病毒护理的记录和公共信息。私人系统没有数据。
