A sociodemographic analysis of the AIDS epidemic in Brazil, 1989-1997

Objective To describe the temporal evolution of AIDS epidemic analyzed from a socio-demographic and behavioral perspective and focusing on the individual educational level. Methods All AIDS cases aged 20 to 69, diagnosed with more than 7 days of difference between the dates of death and of diagnosis and reported to the Ministry of Health Case Report Data Center from 1989 to 1997 were analyzed. Three educational levels were considered: "level I" (less or equivalent to 8 years of schooling), "level II" (more than 8 years of schooling) and "unknown" (no available information). A descriptive analysis of the temporal evolution of the distribution of AIDS cases during the study period was carried out for both sexes and categorized by educational levels, geographic region, county population size, and exposure categories. Multivariate logistic analysis was performed to assess the variables combined effect. Results Information on educational level was not available in 22% of the cases. Where there was available information, higher percentages of "level I" were observed among females, in the southeast and south regions, municipalities with less than 500,000 inhabitants, and in the "heterosexual" and "IDU" exposure categories. For all variables analyzed, it was observed a gradual reduction on the percentages of cases with a higher level of education, in the time period analyzed, for both sexes, less intense among the cases in "homosexual or bisexual" exposure category. Conclusions The AIDS epidemic in Brazil started in social strata of higher educational level, spreading to populations with low educational level, especially among females, as well as to smaller population counties, through heterosexual contacts and use of injecting drugs.