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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorGRANGEIRO, Alexandre
dc.contributor.authorESCUDER, Maria Mercedes Loureiro
dc.contributor.authorCASTILHO, Euclides Ayres de
dc.date.accessioned2017-11-27T16:34:05Z
dc.date.available2017-11-27T16:34:05Z
dc.date.issued2011
dc.identifier.citationCADERNOS DE SAUDE PUBLICA, v.27, suppl.1, p.S114-S128, 2011
dc.identifier.issn0102-311X
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/23365
dc.description.abstractThe aim of this study was to evaluate strategies by the Brazilian Ministry of Health to expand the municipal response to AIDS. Cities ""included"" and ""not included"" in Federal strategies for ""municipalization"" of the response were compared according to the response profile and trends in the epidemic. Multinomial logistic regression was used, among other statistical procedures. Municipalities included from 1994 to 1998 showed higher chances of providing HIV diagnostic testing [OR = 15.0; 95% CI: 5.6-40.1], of having AIDS services [OR = 18.4; 95% CI: 8.4-40.5], and reducing cases involving heterosexual [OR = 3.1; 95% CI: 1.4-7.3], homosexual/bisexual [OR = 3.0; 95% CI: 1.4-6.2], and IDU transmission [OR = 6.6; 95% CI: 2.9-14.9] as compared to those ""included in 2003"" and ""not included"". There were no associations between the included Municipalities, greater coverage in prevention, the reduction in cases due to vertical transmission or blood transfusion, or mortality rates. Municipalities with a more structured response were associated with better results. The findings suggest that the municipalization policy contributed to improvement in the local response to AIDS.
dc.description.abstractAvaliar as estratégias do Ministério da Saúde para ampliar a resposta municipal a AIDS. Cidades "incluídas" e "não incluídas" nas estratégias federais de municipalização foram comparadas segundo perfil da resposta e da epidemia. Regressão logística multinomial foi usada, entre outros procedimentos estatísticos. Municípios incluídos entre 1994/98 apresentaram maior chance de ofertar o diagnóstico do HIV [OR = 15,0; IC95%: 5,6-40,1], possuir serviços de AIDS [OR = 18,4; IC95%: 8,4-40,5] e reduzir casos por transmissão heterossexual [OR = 3,1; IC95%: 1,4-7,3], homo/bissexual [OR = 3,0; IC95%: 1,4-6,2] e uso de drogas injetáveis [OR = 6,6; IC95%: 2,9-14,9] do que os "incluídos em 2003" e os "não incluídos". Não houve associações entre municípios incluídos, a maior cobertura de prevenção e a redução de casos por transmissão vertical, transfusão de sangue e taxas de mortalidade. Municípios com resposta mais estruturada associam-se a melhores resultados. Os achados sugerem que a política de municipalização contribuiu para aprimorar a resposta.
dc.language.isoeng
dc.publisherCADERNOS SAUDE PUBLICA
dc.relation.ispartofCadernos de Saude Publica
dc.rightsopenAccess
dc.subjectAcquired Immunodeficiency Syndrome
dc.subjectProgram Evaluation
dc.subjectDisease Prevention
dc.subjectDescentralization
dc.subjectSíndrome de Imunodeficiência Adquirida
dc.subjectAvaliação de Programas e Projetos de Saúde
dc.subjectPrevenção de Doenças
dc.subjectDescentralização
dc.subject.otherhiv
dc.subject.otherepidemic
dc.subject.otherhiv/aids
dc.subject.otherchallenges
dc.subject.otherprevention
dc.subject.otherprevalence
dc.subject.otherrisk
dc.titleEvaluation of strategies by the Brazilian Ministry of Health to stimulate the municipal response to AIDS
dc.title.alternativeAvaliação de estratégias do Ministério da Saúde para incentivar a resposta municipal a AIDS no Brasil
dc.typearticle
dc.rights.holderCopyright CADERNOS SAUDE PUBLICA
dc.identifier.pmid21503519
dc.subject.wosPublic, Environmental & Occupational Health
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
hcfmusp.author.externalESCUDER, Maria Mercedes Loureiro:Secretaria Estado Saude Sao Paulo, Inst Saude, Sao Paulo, Brazil
hcfmusp.description.beginpageS114
hcfmusp.description.endpageS128
hcfmusp.description.issuesuppl 1
hcfmusp.description.volume27
hcfmusp.origemWOS
hcfmusp.origem.idWOS:000289644800012
hcfmusp.origem.id2-s2.0-79955650437
hcfmusp.publisher.cityRIO DE JANIERO
hcfmusp.publisher.countryBRAZIL
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dc.description.indexMEDLINE
hcfmusp.citation.scopus8
hcfmusp.scopus.lastupdate2022-09-30-
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