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Survival of patients with AIDS and association with level of education level and race/skin color in South and Southeast Brazil: a cohort study, 1998-1999* * Study funded with resources made available by the United Nations Educational, Scientific and Cultural Organization (UNESCO) (Ministry of Health - Project 914/BRA/1101-UNESCO), the Health Surveillance Secretariat (Funding Contract No. 002/06) and the Department of STI, HIV/AIDS and Viral Hepatitis Surveillance, Prevention and Control (IBRD - Agreement No. 4713/BR). This study received support from the Coordination for the Improvement of Higher Level Personnel (CAPES)/Ministry of Education: Funding Code 001.

Abstract

Objective:

to analyze the survival of people with AIDS and association with schooling and race/skin color.

Methods:

this was a retrospective cohort study of people diagnosed with AIDS between 1998 and 1999, in the South and Southeast regions of Brazil. We used survival analysis (Kaplan-Meier method), stratified by schooling and race/skin color and multivariate analysis was performed using Cox regression.

Results:

the study included 2,091 people who had survived at 60 months, with 65% survival among White participants and 62% among Black/brown participants. Irregular use of antiretroviral (HR=11.2 - 95%CI8.8;14.2), and age ≥60 years (HR=2.5 - 95%CI1.4;4.4) were related to lower survival; schooling >8 years (HR=0.4 - 95%CI0.3;0.6) and being female (HR=0.6 - 95%CI0.5;0.8) were positively related to survival; those with less schooling had lower survival.

Conclusion:

lower schooling levels overlap race/skin color differences in relation to survival; these inequalities explain the differences found, despite the policies on universal access to antiretroviral.

Keywords:
Acquired Immunodeficiency Syndrome; Survival; Survival Analysis; Educational Status; Ethnicity and Health

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