Highly active antiretroviral therapy in Brazil: the challenge of universal access in a context of social inequality La terapia antirretrovírica de gran actividad en el Brasil: el reto del acceso para todos en un contexto de desigualdad social

• Main Authors: Mariana A. Hacker, Maya L. Petersen, Melissa Enriquez, Francisco I. Bastos
• Format: Article in Journal/Newspaper
• Language: English; Spanish; Portuguese
• Published: Pan American Health Organization 2004
• Subjects: Acquired immunodeficiency syndrome; antiretroviral therapy; health services; mortality; socioeconomic factors; Brazil; Medicine; R; Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270; Arctic; Sida
• Online Access: https://doaj.org/article/78b5cac91e264a8bb5354581864c7ffd

OBJECTIVE: To investigate trends in AIDS mortality and incidence in Brazil over the period of 1984 to 2000 and to assess the impact of the introduction of universal access to highly active antiretroviral therapy (HAART) in the country in 1996. METHODS: Data from the Brazilian disease notification system and the national mortality information system were used to calculate annual region-specific and sex-specific AIDS incidence and mortality rates. We also calculated sex- and region-specific ratios of the number of AIDS deaths in one year to the number of AIDS cases notified two years earlier. RESULTS: AIDS mortality rates for both men and women and in all five of the geographic regions of Brazil declined following introduction of HAART, despite continued growth in AIDS incidence. The ratio of the number of AIDS deaths in one year to the number of AIDS cases notified two years earlier for men equalized rapidly with the ratio for women following introduction of HAART. More recently, AIDS incidence declined for both sexes and in most of the regions of Brazil. CONCLUSIONS: Despite Brazil's resource limitations and disparities in wealth between men and women and among the country's regions, the introduction of universal access to HAART in Brazil has helped achieve impressive declines in AIDS mortality, and it may also be contributing to declines in AIDS incidence. OBJETIVO: Investigar las tendencias que han mostrado la mortalidad y la incidencia del sida en el Brasil durante el período de 1984 a 2000 y evaluar el efecto de la introducción en el país en 1996 de la terapia antirretrovírica de gran actividad (TAGA) accesible a toda la población. MÉTODOS: Se usaron datos procedentes del sistema de notificación de enfermedades del Brasil y del sistema nacional de información sobre mortalidad para calcular las tasas de incidencia y de mortalidad por sida en cada región del país y según el sexo. También calculamos para cada región y según el sexo, las razones dadas por el número de muertes por sida en un año contra el número ...