| Issue/Objective |
Analysis of causes of death among people living with HIV and AIDS
(PLWHA) is essential for monitoring the effectiveness of the HIV care continuum and guiding interventions to reduce avoidable mortality. Despite Brazil's universal antiretroviral therapy program, AIDS-related mortality persists with marked sociodemographic and regional disparities. This study analyzed factors associated with AIDS-related and non-AIDS-related mortality among PLWHA aged 15 years and older in Brazil between 2015 and 2024. |
| Methodology/Approach |
We analyzed real-life data from a linked national dataset integrating
HIV/AIDS case notifications, antiretroviral therapy dispensations, CD4 and viral load test results, and mortality records from 2015 to 2024. All causes of death were included. Underlying causes were classified as HIV/AIDS-related (ICD-10 codes B20-B24) or non-AIDS-related, and their distribution was examined by year. Logistic regression modelling identified sociodemographic and contextual factors independently associated with AIDS-related mortality. |
| Results |
Between 2015 and 2024, 162,061 PLWHA died in Brazil, of whom 112,004 (69%) died from AIDS-related causes. The proportion of AIDS-related deaths decreased from 77% in 2015 to 60% in 2024, reflecting treatment program gains. However, persistent inequalities remained. Younger individuals, residents of the North region, and those with lower educational attainment showed the highest proportions of AIDS as the underlying cause of death. Logistic regression confirmed that older age, higher education, and more recent calendar years were independently associated with reduced odds of AIDS-related mortality. Critically, mixed-race and Black individuals had significantly higher odds of AIDS-related mortality compared with White individuals. Individuals living in wealthier macro-regions had consistently lower odds of dying from AIDS than those in poorer regions. |
| Discussion/Conclusion |
AIDS mortality in Brazil is not random-it reflects persistent sociodemographic and regional inequalities that a universal health system alone has not eliminated. Black, mixed-race, younger, and less-educated populations in poorer regions remain disproportionately affected. These findings underscore the urgent need for equity-focused policies prioritizing early diagnosis, timely antiretroviral therapy initiation, and comprehensive advanced HIV disease management, with the Healthy Brazil Program providing an intersectoral framework for addressing these inequities. |
| Presenters and Affiliations |
Gashaija Absolomon Centre for Impact, Innovation and Capacity building for Health Information Systems and Nutrition (CIIC-HIN), Kigali, Rwanda |
