Differential trends in mortality from AIDS in men and women in Brazil (1984-1995)

Objective: To analyse trends in AIDS mortality in men and women in Brazil, for the period 1984-1995. Design and methods: National statistics on yearly numbers of reported death s by cause, in conjunction with census population counts and inter-censory estimates, were used to calculate age- and sex-specific AIDS mortality rate s for Brazil as a whole and for Sao Paulo and Rio de Janeiro, the two large st cities in Brazil, and those most affected by the AIDS epidemic to date. Results: Numbers of reported deaths from AIDS have increased yearly in Braz il since 1984, to approximately 15 000 in 1995. The data suggest that a aft er a very dramatic rise in mortality rates, the epidemic may have started t o slow even before the introduction of freely available highly-active anti- retroviral therapy, although unequally in terms of both geographical and se x distributions. Women also tended to die at relatively younger ages than m en in all areas studied, and by 1995 the impact of AIDS on overall mortalit y was practically the same for men and women aged 25-34 years (21% in Sao P aulo). Conclusions: Trends in mortality from AIDS in Brazil reflect both the geogr aphical expansion of the epidemic outwards from its original epicentres, an d the fact that women are becoming increasingly affected by the AIDS epidem ic. (C) 2000 Lippincott Williams & Wilkins.