title: Trends in AIDS-related mortality among people aged 60 years and older in Brazil: a nationwide population-based study.
abstract: The success of antiretroviral therapy has led to an increase in the number of older people living with human immunodeficiency virus worldwide. This study analyzed the epidemiological patterns and time trends of acquired immunodeficiency syndrome (AIDS) related mortality in people aged 60 and older in Brazil from 2000 to 2011. Secondary mortality data from the Brazilian Mortality Information System was used to perform a nationwide population-based study, which included all AIDS-related deaths among people aged 60 years and older in Brazil from 2000 to 2011. Crude and age-adjusted mortality rates (per 100,000 inhabitants) were calculated by sex, age group and place of residence. Trends over time were assessed using joinpoint regression analysis. In the 12-year study period, 12,491,280 deaths were recorded in Brazil, of which 144,175 were AIDS-related deaths. A total of 8194 AIDS-related deaths was identified in people aged 60 years and older (0.12% of all deaths and 5.7% of AIDS-related deaths). The overall age-adjusted mortality rate for the period was 4.30 deaths/100,000 inhabitants (95% confidence interval: 3.99-4.64). Males (6.45 deaths/100,000 inhabitants), aged 60-64 years (6.63 deaths/100,000 inhabitants) and residing in the South region (5.94 deaths/100,000 inhabitants) had the highest mortality rates. We observed a significant increase in mortality at the national level and in all the Brazilian regions, with a sharper increase in the most socioeconomically disadvantaged regions of the country, such as the North and Northeast. The findings show that AIDS in older people is an increasing public health problem in Brazil, and reinforce the need to establish public policies for the prevention, early diagnosis and appropriate clinical treatment of this age group.
authors.affiliation: a São José Hospital of Infectious Diseases , Fortaleza , Brazil.|b Department of Community Health, School of Medicine , Federal University of Ceará , Fortaleza , Brazil.
authors.forename: Mauricélia da Silveira
authors.initials: MD
authors.lastname: Lima
authors.affiliation: c Federal Institute of Education, Science and Technology of Ceará , Caucaia , Brazil.
authors.forename: Andréa Acioly Maia
authors.initials: AA
authors.lastname: Firmo
authors.affiliation: b Department of Community Health, School of Medicine , Federal University of Ceará , Fortaleza , Brazil.|c Federal Institute of Education, Science and Technology of Ceará , Caucaia , Brazil.
authors.forename: Francisco Rogerlândio
authors.initials: FR
authors.lastname: Martins-Melo
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000401:mortality*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D011204:Poverty Areas; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012737:Sex Factors
keywords: AIDS; Brazil; HIV; Older adults; mortality