Evaluation of strategies by the Brazilian Ministry of Health to stimulate the municipal response to AIDS

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.author GRANGEIRO, Alexandre FMUSP-HC
ESCUDER, Maria Mercedes Loureiro
CASTILHO, Euclides Ayres de FMUSP-HC
dc.date.issued 2011
dc.identifier.citation CADERNOS DE SAUDE PUBLICA, v.27, suppl.1, p.S114-S128, 2011
dc.identifier.issn 0102-311X
dc.identifier.uri http://observatorio.fm.usp.br/handle/OPI/23365
dc.description.abstract The 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.abstract Avaliar 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.iso eng
dc.publisher CADERNOS SAUDE PUBLICA
dc.relation.ispartof Cadernos de Saude Publica
dc.rights openAccess
dc.subject Acquired Immunodeficiency Syndrome; Program Evaluation; Disease Prevention; Descentralization; Síndrome de Imunodeficiência Adquirida; Avaliação de Programas e Projetos de Saúde; Prevenção de Doenças; Descentralização
dc.subject.other hiv; epidemic; hiv/aids; challenges; prevention; prevalence; risk
dc.title Evaluation of strategies by the Brazilian Ministry of Health to stimulate the municipal response to AIDS
dc.title.alternative Avaliação de estratégias do Ministério da Saúde para incentivar a resposta municipal a AIDS no Brasil
dc.type article
dc.rights.holder Copyright CADERNOS SAUDE PUBLICA
dc.description.group LIM/39
dc.identifier.pmid 21503519
dc.type.category original article
dc.type.version publishedVersion
hcfmusp.author GRANGEIRO, Alexandre:HC:LIM/39
hcfmusp.author CASTILHO, Euclides Ayres de:FM:MPR
hcfmusp.author.external · ESCUDER, Maria Mercedes Loureiro:Secretaria Estado Saude Sao Paulo, Inst Saude, Sao Paulo, Brazil
hcfmusp.origem.id WOS:000289644800012
hcfmusp.origem.id 2-s2.0-79955650437
hcfmusp.publisher.city RIO DE JANIERO
hcfmusp.publisher.country BRAZIL
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dc.description.index MEDLINE
hcfmusp.citation.scopus 7
hcfmusp.affiliation.country Brasil
hcfmusp.scopus.lastupdate 2021-08-27


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