Geographic expression of AIDS epidemic in Campinas, Southeastern Brazil, between 1980 and 2005

Abstract

OBJECTIVE: To analyze the spatial distribution of reported AIDS cases in adults and its association with living conditions in the city of Campinas, Southeastern Brazil. METHODS: Data on AIDS cases in men (n=2,945) and women (n=1,230) aged more than 13 years and living in Campinas, recorded in the SINAN (Brazilian Information System for Notifiable Diseases), were used to map the spatial distribution of this disease and the male:female ratio. Maps were constructed for the following periods: from 1980 to 1995, from 1996 to 2000, and from 2001 to 2005. The variables included in the analysis were address, sex and age. A weighted composite index was used to study living and health conditions in the area. Patients' home addresses were geocoded on a cartographic base, after correction and standardization according to a reference database of streets. A generalized additive model was adjusted to analyze the spatial distribution of the ratio of male:female cases in space, in the three study periods. RESULTS: The ratio of male:female cases was higher in areas with better living conditions (central) and around the prison (northwestern), where families of prisoners and former prisoners live temporarily, while this ratio was lower in the city suburbs (southwestern). CONCLUSIONS: The trends towards the AIDS epidemic affecting more women and poorer individuals were confirmed by the decrease in the ratio of male:female cases in the period, particularly in vulnerable and impoverished populations. Geographic information systems and spatial data analysis can be useful for AIDS control and surveillance actions.