Introduction: In Brazil, the HIV/AIDS detection rate (/100,000 inhab.) showed a decrease in
the general population of 17.2%, from 2009 (21.5) to 2019 (17.8). However, this rate increased
substantially among the young population, which had the highest detection rate in the country,
52.0 (/100,000 inhab.) (BRASIL, 2020a). This advance on the young population is due to
obstructions, discrimination, inequalities, stigmas and social and health inequities, intrinsic
vulnerabilities of this population stratum that enhance their chances of becoming infected with
HIV. However, the risk of HIV infection cannot be conditioned only to the individual, since
behaviors are directly influenced by socioeconomic territorial factors that exceed the individual.
Despite all the advancement of HIV among young people, there is a scarcity of studies aimed
at analyzing the impact of Social Determinants of Health (SDH) on the epidemic in this age
group. Objective: To analyze temporally and spatially the HIV epidemic among young people
in the State of Pará. Methods: An ecological study that analyzed HIV/AIDS cases diagnosed
between 2007 and 2018 in Pará, Brazil. An exploratory analysis was performed using
descriptive statistics. The temporal projections (2019-2022) used mixed method, ARIMA +
STL in the RStudio software. For the spatial analysis, we used statistical scanning techniques
to obtain the Relative Risk (RR), with a confidence interval of 95%; Moran's autocorrelation
statistic considering statistically significant (p < 0.05) for building the LISAMap in ArcGIS
software. In SPSS software, we developed models from Ordinary Least Squares (OLS) and
later by Geographically Weighted Regression (GWR), with spatial analysis of residuals, with
the help of MGWR and ArcGIS software. Results: Of the 8,143 cases analyzed, 47.97% were
young people between 25 and 29 years old, men (66.46%), mixed race (76.95%), living in urban
areas (85.20%) and heterosexuals (54 .41%). An expansion of HIV among young people in
Pará was identified, with a temporal projection of increase for young people aged 20-24 years.
Spatial variability of DSS: 'Basic Education Development Index'; doctors per 10,000
inhabitants and municipal high school abandonment (MHSA) rate were associated with the risk
of HIV infection among young people. The relative risk showed spatial variability.
Conclusions: The SDH associated with HIV risk among young people in Pará, show social
particularities of HIV in the study region and should be considered in the formulation of policies
to reach the global goal of eliminating AIDS by 2030 among young people.
|
