Survival time and distance to access specialized treatment among people living with HIV/Aids in the state of Alagoas, Brazil

• Published in: Revista brasileira de epidemiologia Vol. 24; no. suppl 1; p. e210019
• Main Authors: Melo, Géssyca Cavalcante de, Carvalho, Aline Carla Araújo, Moreira, Anderson da Silva, Paixão, Julya Thereza Dos Santos
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Associação Brasileira de Pós -Graduação em Saúde Coletiva 2021; Associação Brasileira de Pós-Graduação em Saúde Coletiva
• Subjects: Acquired immunodeficiency syndrome; Acquired Immunodeficiency Syndrome - therapy; Adolescent; Brazil - epidemiology; Health Policy & Services; Health Services; Health services accessibility; Health status disparities; HIV; HIV Infections - therapy; Humans; Mortality; Survival analysis; Brazil; Survival analysis; Health status disparities; Análise de sobrevida; Acesso aos serviços de saúde; Disparidades nos níveis de saúde; HIV; Mortality; Síndrome da imunodeficiência adquirida; Acquired immunodeficiency syndrome; Mortalidade; Health services accessibility
• ISSN: 1415-790X; 1980-5497
• DOI: 10.1590/1980-549720210019.supl.1

To evaluate the effect of the distance between the place of residence and the specialized treatment service on the survival time of people living with HIV/Aids in Alagoas, Northeast Brazil. Data from the notification and mortality systems related to individuals aged 13 years or older diagnosed with the infection between 2007 and 2013 were used. The cases were observed for a period of follow-up until December 2017. For the analyses, the Pearson's χ2 test, Kaplan-Meier method, and Cox regression were adopted according to the outcome of the case, place of residence, distance to the health unit, population size of the municipality of residence, sex, skin color/ethnicity, and age. Of the 2,732 analyzed cases, 760 individuals died of Aids-related causes. The average estimate of survival time for individuals residing in the capital was 98.6 months (95%CI 96.1-101). Among residents of inland cities, the estimate was 92.7 months (95%CI 89.3-96.1). There was a significant difference in curves throughout the period. The group residing in inland municipalities and those traveling a distance of >70 km had a higher average relative risk of death (RR=1.21, 95%CI 1.05-1.4 and RR=1.18, 95%CI 1.01-1.39, respectively). Living in or near the capital decreases the average relative risk of death. In order to increase the survival time of HIV/Aids patients in Alagoas, it is suggested to decentralize specialized health care, that is, to create regional centers to care for these people.