Human immunodeficiency virus/acquired immunodeficiency syndrome epidemic in adolescents from a Brazilian metropolis (1978-2017)

Taquette, Stella Regina; Rodrigues, Nádia Cristina Pinheiro

doi:10.1590/0037-8682-0193-2019

Brasil

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Short Communication • Rev. Soc. Bras. Med. Trop. 53 • 2020 • https://doi.org/10.1590/0037-8682-0193-2019 linkcopy

Human immunodeficiency virus/acquired immunodeficiency syndrome epidemic in adolescents from a Brazilian metropolis (1978-2017)

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

INTRODUCTION: Prevalence of human immunodeficiency virus among adolescents is increasing. This study aimed to analyze this current situation in Rio de Janeiro City.

METHODS: This was a retrospective longitudinal study using secondary data from the National System of Notifiable Diseases database of cases in adolescents aged 13-19 years.

RESULTS: There were 885 acquired immunodeficiency syndrome cases from 1978 to 2017 and 445 human immunodeficiency virus new cases from 2014 to 2017. Over time, sexually transmitted human immunodeficiency virus/acquired immunodeficiency syndrome cases increase.

CONCLUSIONS: Human immunodeficiency virus/acquired immunodeficiency syndrome epidemic in adolescents requires novel prevention policies.

Keywords: HIV-AIDS; Adolescence; Prevention & control; Health vulnerability; Public policies; Social control

	Total	Diagnostic moment				P-v
		1978-1987	1988-1997	1998-2007	2008-2017
AIDS
Morbidity
n (%)	885 (100)	24 (3)	178 (20)	339 (38)	344 (39)
Sex						0.0001
Female - n (%)	429 (49)	5 (1)	57 (14)	190 (44)	177 (41)
Male - n (%)	456 (51)	19 (4)	121 (27)	149 (33)	167 (36)
Ratio between sexes (men/10 women)	11	38	21	8	9
Rate/100,000	3	0	3	5	5
Sex
Female - rate/100,000	3	0	2	6	5
Male - rate/100,000	3	1	4	4	5
Mortality
n (%)	190 (22)	18 (10)	80 (42)	58 (30)	34 (18)
Sex						0.001
Female - n (%)	66 (35)	2 (3)	23 (35)	32 (49)	9 (14)
Male - n (%)	124 (65)	16 (13)	57 (46)	26 (21)	25 (20)
Ratio between sexes (men/10 women)	19	80	25	8	28
Rate/100,000	0	0	0	0	0
Sex
Female - rate/100,000	0	0	2	1	1
Male - rate/100,000	1	1	1	1	0
HIV infection		2014	2015	2016	2017
n (%)	445 (100)	79 (18)	136 (31)	117 (26)	113 (25)
Sex						0.05
Female	204 (46)	47 (23)	61 (30)	47 (23)	49 (24)
Male	241 (54)	32 (13)	75 (31)	70 (29)	64 (27)
Total - n (%)	445 (100)	79 (18)	136 (31)	117 (26)	113 (25)
Ratio between sexes (men/10 women)	12	7	12	15	13
Rate/100,000	16	12	20	17	16
Sex
Female	15	14	18	14	14
Male	17	9	22	20	18

	Total	Diagnostic moment				P-v
		1978-1987	1988-1997	1998-2007	2008-2017
AIDS
Median (IQR)
Age	18 (3)	17 (3)	18 (2)	18 (3)	18 (3)	0.04
Interval - diagnosis/notification (months)	3 (32)	16 (96)	11 (49)	9 (57)	2 (7)	0.0001
n (%)
Ethnic
White	199 (37)	0 (0)	6 (3)	90 (45)	103 (52)	0.10
Non-White	335 (63)	3 (1)	11 (3)	119 (36)	202 (60)
Pregnant	65 (15)	0 (0)	0 (0)	11 (17)	54 (83)	0.0001
Educational level
< Elementary school	381 (57)	9 (2)	88 (23)	185 (49)	99 (26)	0.0001
Elementary school	204 (31)	7 (3)	40 (20)	68 (33)	89 (44)
Middle/high school	80 (12)	0 (0)	3 (4)	18 (23)	59 (73)
Transmission
Blood	56 (2)	14 (24)	24 (43)	7 (13)	11 (20)	0.0001
Type
Transfusion	3 (5)	0 (0)	1 (33)	2 (67)	0 (0)	0.38
Hemophilia	24 (43)	10 (42)	13 (54)	0 (0)	1 (4)	0.0001
Injectable drugs	29 (52)	4 (14)	10 (34)	5 (17)	10 (35)	0.001
Sexual	319 (36)	3 (1)	5 (1)	95 (30)	216 (68)	0.0001
Type
Women
Heterosexual	179 (95)	1 (1)	3 (2)	63 (34)	112 (63)	0.70
WSW	8 (4)	0 (0)	0 (0)	2 (25)	6 (75)
Bisexual	2 (1)	0 (0)	0 (0)	0 (0)	2 (100)
Men
Heterosexual	30 (23)	0 (0)	2 (6)	11 (37)	17 (57)	0.01
MSM	90 (69)	1 (1)	0 (0)	19 (21)	70 (78)
Bisexual	10 (8)	1 (10)	0 (0)	0 (0)	9 (90)
Vertical	99 (11)	0 (0)	2 (2)	30 (30)	67 (68)	0.0001
HIV infection		2014	2015	2016	2017
Median (IQR)
Age	18 (2)	18 (2)	18 (2)	18 (2)	19 (2)	0.97
Interval - diagnosis/notification (days)	12 (88)	69 (266)	16 (113)	8 (82)	0 (14)	0.0001
n (%)
Ethnic
White	104 (26)	16 (15)	40 (39)	28 (27)	20 (19)	0.11
Non-White	295 (74)	58 (20)	78 (26)	80 (27)	79 (27)
Pregnant	86 (42)	19 (22)	30 (35)	19 (22)	18 (21)	0.59
Educational level
< Elementary school	148 (46)	29 (20)	39 (26)	42 (28)	38 (26)	0.38
Elementary school	124 (38)	24 (19)	39 (32)	30 (24)	31 (25)
Middle/high school	51 (16)	6 (12)	22 (43)	14 (28)	9 (17)
Transmission
Blood	9 (2)	4 (45)	2 (22)	2 (22)	1 (11)	0.28
Type
Transfusion	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	1.00
Hemophilia	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	1.00
Injectable drugs	9 (100)	4 (42)	2 (25)	2 (25)	1 (8)	0.28
Sexual	366 (82)	62 (17)	118 (32)	91 (25)	95 (26)	0.20
Type
Women
Heterosexual	164 (98)	36 (22)	54 (33)	35 (21)	39 (24)	0.35
WSW	1 (1)	0 (0)	1 (100)	0 (0)	0 (0)
Bisexual	3 (2)	0 (0)	0 (0)	1 (33)	2 (67)
Men
Heterosexual	49 (25)	6 (11)	15 (31)	16 (33)	12 (25)	0.84
MSM	127 (64)	15 (12)	42 (33)	34 (27)	36 (28)
Bisexual	22 (11)	5 (23)	6 (27)	5 (23)	6 (27)
Vertical	35 (9)	4 (11)	9 (26)	15 (43)	7 (20)	0.18

	Simple models		Adjusted model
	OR	95% CI	OR	95% CI
Fixed effects
Male	2.05	1.32-3.22	2.12	1.36-3.32
Age	0.88	0.78-1.01
Nonwhite race	0.65	0.39-1.10
Year	0.86	0.84-0.88
Educational level
< Elementary school	1.00		1.00
Elementary school	0.41	0.24-0.67	0.42	0.25-0.69
Middle/High school	0.27	0.09-0.65	0.37	0.13-0.94
Transmission
Blood vs. others
Transfusion	1.16	0.07-19.88
Hemophilia	1.56	0.46-5.25
Injectable drugs	2.90	1.04-7.83	3.15	1.29-7.58
Sexual vs. others	0.12	0.06-0.22	0.08	0.04-0.13
Vertical vs. others	0.25	0.07-0.75	0.11	0.03-0.33

Random effects			Mean
Intercept (neighborhood)			18,629	1,266-67,205
Slope (year)			18,527	1,242-67,031
Slope (HDI)			18,630	1,268-67,203
Deviance			578

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Sociedade Brasileira de Medicina Tropical - SBMT Sociedade Brasileira de Medicina Tropical - SBMT, Núcleo de Medicina Tropical UnB, Sala 43C 70904-970, E-mails: rsbmt@uftm.edu.br | artes.rsbmt@gmail.com | sbmt@sbmt.org.br , WhatsApp: SBMT (61) 9.9192-6496, WhatsApp: RSBMT (34) 9.9996-5807 - Brasília - DF - Brazil
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[TFN1] P-v: p-value; ratio between sexes, number of cases/deaths in men for each 10 cases/deaths in women.