Spatiotemporal analysis of the HIV epidemic in older people in a Brazilian Amazon state

Abstract

Objective

To analyze spatiotemporally the incidence of the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) among older people in the State of Pará, Brazil, from 2007 to 2018.

Method

An ecological study of HIV/AIDS case notifications in older people from the Brazilian Information System on Notifiable Diseases. The HIV/AIDS incidence rate was temporally analyzed by the joinpoint method, and spatially by the Moran autocorrelation of scanning and spatial regression techniques.

Results

2,639 notifications of HIV/AIDS were eligible for the study, with 1,725 (65.4%) being in men and 914 (34.6%) in women. During the study period, there was an increase of 2,422.5% in the HIV incidence rate in men and 1,929.8% in women, with the opposite being observed for the AIDS incidence rate, which increased 77.6% in women and 40.7% in men. The joinpoint method showed an increasing trend for the HIV incidence rate (APC=30%, p=0.00) and stability for the AIDS incidence rate (APC=3.0%, p=0.2). The most impacted municipalities by the HIV epidemic were those in the south-eastern part of Pará, with a moderate association (R²=0.65) with its population growth. The spatiotemporal scanning analysis pointed to Belém as a risk zone for HIV/AIDS (RR=3.93, p=0.00; 2017-2018).

Conclusion

While the incidence of AIDS among older people from Pará remained stable from 2007 to 2018, that of HIV tended to grow. The greatest impact of the epidemic occurred in southeastern Pará municipalities, and it was associated with the population growth; Belém presented a spatiotemporal risk for HIV/AIDS.

Keywords
Spatial Analysis; HIV; Health of the Elderly