Banca de QUALIFICAÇÃO: KAREN KALINE DOS SANTOS TEIXEIRA

Uma banca de QUALIFICAÇÃO de MESTRADO foi cadastrada pelo programa.
STUDENT : KAREN KALINE DOS SANTOS TEIXEIRA
DATE: 26/12/2025
TIME: 08:30
LOCAL: Remoto
TITLE:

Spatial Distribution and Survival of People Living with HIV/AIDS in Natal, Rio Grande do Norte

KEY WORDS:

Keywords: HIV; Spatial Distribution; Survival Analysis; Tuberculosis; Social Vulnerability

PAGES: 58
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUBÁREA: Saúde Pública
SUMMARY:

Introduction: The HIV/AIDS epidemic remains a major public health challenge in Brazil, particularly in regions marked by social inequalities and territorial vulnerabilities. Objective: To analyze the spatial distribution and factors associated with the survival of people living with HIV/AIDS in the city of Natal, Rio Grande do Norte, Brazil. Methods: Two methodological approaches were developed. (1) An ecological time-series study examined spatial variations in HIV/AIDS prevalence between 2018 and 2022 using data from the Notifiable Diseases Information System (SINAN) and spatial statistical modeling with SaTScan. (2) A retrospective cohort study included individuals diagnosed with HIV/AIDS between 2019 and 2023, based on linked SINAN and Mortality Information System (SIM) data. Survival was estimated using the Kaplan-Meier method, and factors associated with mortality were evaluated through Cox regression. Results: (1) A total of 2,433 georeferenced cases were identified, revealing nine significant spatial clusters, mainly concentrated in the northern and western zones of the city— areas characterized by greater social vulnerability and limited access to health services. The relative risk of the primary cluster was 3.14 (p < 0.001). (2) Among the 1,882 individuals diagnosed with HIV, 7.9% presented TB-HIV coinfection and 3.3% progressed to death. Survival was significantly lower among coinfected individuals (p < 0.001). In the adjusted analysis, TB-HIV coinfection remained the strongest determinant of mortality (aHR = 5.55; 95% CI: 3.21–9.58). Older age and low educational level were also associated with higher mortality risk, particularly in the 40–59 age group (aHR = 5.35) and among those aged ≥ 60 years (aHR = 9.85). Conclusions: The spatial distribution and temporal dynamics of HIV/AIDS cases indicate that peripheral areas exhibited higher case concentrations and represent priority territories for surveillance and intervention. Mortality remains strongly driven by TB-HIV coinfection, advanced age, and low educational attainment, highlighting the need for integrated strategies for diagnosis, clinical management, and territorial actions targeting the most vulnerable populations. 

COMMITTEE MEMBERS:
Presidente - 421717 - MARIA ANGELA FERNANDES FERREIRA
Interno - 1149540 - ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
Externo ao Programa - 2580109 - EWERTON WILLIAM GOMES BRITO - UFRN