Banca de DEFESA: KAREN KALINE DOS SANTOS TEIXEIRA

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : KAREN KALINE DOS SANTOS TEIXEIRA
DATE: 05/02/2026
TIME: 09:00
LOCAL: Google Meet
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: 56
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
Externo ao Programa - 2580109 - EWERTON WILLIAM GOMES BRITO - UFRNExterno à Instituição - YAN NOGUEIRA LEITE DE FREITAS - UFAM