Introduction: Since the discovery of the Human Immunodeficiency Virus (HIV) and acquired
immunodeficiency syndrome (AIDS) in the early 80s, the epidemic has become a serious public
health problem due to its rapid worldwide dissemination. In Brazil, although the average
detection rate of HIV and AIDS have shown a reduction of 9.4% in the last ten years, the North
and Northeast regions showed growth (44.2% and 24.1%, respectively). Pará occupies the 8th
position at national level in detection rate of HIV and AIDS (23.6 cases per 100,000 inhab.).
Objective: to analyze the historical series of the HIV epidemic in the State of Pará. This study
is a ecological time series, in which secondary data collected from the Notification Disease
Information System were analyzed between 2007 and 2018 in the 144 municipalities of the
State. The following variables were used: gender, age, race / color, education, exposure
category and municipality of residence. Only residents in Pará and those over thirteen years old
were included in the study. To calculate the incidence rate of HIV and AIDS, the number of
new cases of HIV and AIDS among residents over 13 years old was considered as variable,
divided by the number of the total population residing in the same age group in the
municipalities, regions and state and multiplied the ratio by 100,000. Annual percentage
changes (APC) in incidence rates were calculated using Joinpoint modeling. For the analysis of
epidemiological variables between the two defined periods, the chisquare test and residual
analysis were used. P≤0.05 values were considered statistically significant. Results: The
incidence rates of HIV and AIDS in 2007 and 2018 increased by 420%. An inflection point was
identified for the series, separating it into two trend periods: 2007 to 2012 (G1) and 2012 to
2018 (G2). In G1, the incidence increased with an annual percentage variation of 1.6% (CI =
15.0 to 21.5; p≤0.05), while in G2, the variation was 29.8% (CI = 19.9 at 40.5; p≤0.05). Changes
in age and education profile were observed between G1 and G2: in G1, adults with low levels
of education were the most affected by the epidemic, while in G2, the young population with
high levels of education. According to the analysis of the HIV infection trends together with
the exploration of the socioeconomic dynamics of the municipalities whose HIV cases were
more frequent in each of the state's mesoregions (Oriximiná, Belém, Bragança, Abaetetuba,
Marabá, Parauapebas and Altamira). The incidence was higher in municipalities with better
socioeconomic conditions, but with lower coverage of the Family Health Strategy. Identifying
changes in the profile of new infections direct the visualization of key populations, as well as
localized epidemics and their dissemination forms for the adoption of public health policies
competent for the management of HIV infection.
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