Spatiotemporal patterns in the incidence of AIDS in São Paulo city, Brazil

Author(s)

Elisângela Aparecida da Silva Lizzi

• Document type: Doctoral Thesis
• Press: Ribeirão Preto.
• Institution: Universidade de São Paulo (USP). Faculdade de Medicina de Ribeirão Preto (PCARP/BC)
• Defense date: 2015-07-21

Examining board members

Edson Zangiacomi Martinez; Amaury Lelis Dal Fabbro; Marcio Poletti Laurini; Ethel Leonor Noia Maciel; Afonso Dinis Costa Passos

• Advisor: Edson Zangiacomi Martinez

Abstract

This study aims to investigate the spatiotemporal patterns of reported AIDS cases between the years 2000 to 2010 in São Paulo, SP, according to its 96 Administrative Districts, and their associations with sociodemographic characteristics and social vulnerability of these areas. This is an ecological study, and the tools used to incidence rates estimation and analysis of data is Bayesian regression models that incorporate spatial and temporal effects. These models include random effects with a CAR distribution (conditional autoregressive) bivariate normal that capture the influence of adjacent fields on the number of cases reported in each region, according to sex. Estimates of the model parameters were obtained by stochastic simulation method MCMC (Monte Carlo Markov Chain). The spatiotemporal pattern found in this work shows historical traces of the AIDS epidemic in Brazil and the study stratified by gender in the course of the disease for the years under study reveals behavioral aspects of transmission in populations at risk. Can show that the Administrative Districts with better economic classes had higher incidence of the disease in males, since areas with less favored economic classes had higher incidence rates of AIDS among women, justified by the AIDS pauperization and feminization. The results are useful to support the policy planning and health actions directed to the control of AIDS in areas and populations of diverse risk by gender in São Paulo. It emphasizes the need for diversified operations by Administrative District in access to health services, gender, in order to propose a service strategy to separate men and women for areas and providing different support teams to the area with particular characteristics. The bayesian approach proposed proved satisfactory to indicate areas that need more attention as the need for health services, human development and vulnerability. (AU)

• FAPESP's process: 12/16717-9 - SPATIO-TEMPORAL PATTERNS OF INCIDENCE OF AIDS IN THE CITY OF SÃO PAULO, BRAZIL.
• Grantee: Elisangela Aparecida da Silva Lizzi
• Support Opportunities: Scholarships in Brazil - Doctorate