Bastos F I, Barcellos C
Departamento de Informações, Ciência e Tecnologia da Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Rev Saude Publica. 1995 Feb;29(1):52-62. doi: 10.1590/s0034-89101995000100009.
The first of a series of papers concerning the evaluation of the dynamics of the AIDS epidemic in Brazil employing techniques of geographical analysis, is here presented. Results of research undertaken in the US (especially in New York City) are compared with those of a recent investigation carried out in the city of S.Paulo, Brazil (Grangeiro, 1994). In both, geographical patterns of socio-demographic variables correlate with different patterns of the spread of the AIDS epidemic through the transmission groups. Recent trends of the AIDS epidemic in Brazil: the displacement toward medium sized cities and expansion frontiers, increasing report of AIDS cases among the poor and underprivileged, changes in the pattern of transmission with proportional augmentation of heterosexual transmission and IDUs as transmission groups, are described and analysed. The geographical distribution of the AIDS cases registered between 1987-1993 in Brazil throughout the Brazilian States is evaluated by means of worksheets, maps, and non-parametric statistics. Results show that Gravimetric Centers (obtained by the use of the calculus spatial means) of AIDS in Brazil are situated within a triangle the sides of which are formed lines joining the three main metropolitan areas of the wealthiest region of Brazil--the southeast, i.e. São Paulo, Rio de Janeiro and Belo Horizonte. These especially S. Paulo, function as points of attraction for these Gravimetric Centers (GCs) towards the south as compared with the GCs of the general population calculated ia accordance with data from the 1980 and 1991 censuses. It is possible to observe a displacement of the GCs toward the northwest over this period in accordance with the migration patterns of the Brazilian population in general, though with a dynamic of its own. These changes in the geographical, socio-demographic and transmission group patterns show the complex nature of the epidemic in Brazil and pose additional difficulties for the development of prevention strategies.
本文呈现了一系列关于运用地理分析技术评估巴西艾滋病疫情动态的论文中的第一篇。美国（尤其是纽约市）的研究结果与巴西圣保罗市最近的一项调查（格兰热罗，1994年）结果进行了比较。在这两项研究中，社会人口统计学变量的地理模式都与艾滋病疫情通过传播群体传播的不同模式相关。描述并分析了巴西艾滋病疫情的近期趋势：向中等规模城市和扩张前沿的转移、贫困和弱势群体中艾滋病病例报告的增加、传播模式的变化以及异性传播和注射吸毒者作为传播群体的比例增加。通过工作表、地图和非参数统计评估了1987 - 1993年巴西全国各州登记的艾滋病病例的地理分布。结果表明，巴西艾滋病的重心（通过空间均值计算得出）位于一个三角形内，该三角形的边由连接巴西最富裕地区东南部的三个主要大都市——圣保罗、里约热内卢和贝洛奥里藏特的直线构成。与根据1980年和1991年人口普查数据计算得出的一般人口重心相比，这些城市，尤其是圣保罗，对这些重心向南起到吸引作用。在此期间，可以观察到重心随着巴西总体人口的迁移模式向西北方向移动，尽管有其自身的动态变化。这些地理、社会人口统计学和传播群体模式的变化显示了巴西疫情的复杂性，并给预防策略的制定带来了额外困难。
