Survival time and distance to access specialized treatment among people living with HIV/Aids in the state of Alagoas, Brazil

Abstract

Objective: to evaluate the effect of the distance between the place of residence and specialized treatment on the survival time of people living with HIV/Aids in Alagoas, Northeast Brazil. Methods: data from the notification and mortality systems related to individuals aged 13 years or older diagnosed with the infection between 2007 and 2013 were used. The cases were observed for a period of follow-up until December 2017. The test was adopted Pearson's chi-square, Kaplan Meier method and Cox regression for analyzes according to the outcome of the case, place of residence, distance to the health unit, population size of the municipality of residence, sex, color/ethnicity and age. Results: Of the 2732 cases analyzed, 760 died of Aids-related causes. The average estimate of survival time for individuals residing in the capital was 98.6 months (CI 95%: 96.1–101). Among residents in the interior cities, the estimate was 92.7 months (CI 95%: 89.3–96.1). There was a significant difference in curves throughout the period. The group residing in the interior and those traveling at a distance> 70 km had a higher average risk of death (RR 1.21, CI 95%: 1.05–1.4 and RR 1.18, 95% CI 95%: 1, 01-1.39, respectively). Conclusion: living in or near the capital decreases the average relative risk of death. In order to increase the survival time of HIV / AIDS patients in Alagoas, it is suggested to decentralize specialized assistance, that is, to create regional centers to care for these people.