{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:23:47Z","timestamp":1786116227294,"version":"build-2736575974"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100008132","name":"Universidade Federal De Pernambuco","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100008132","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Community Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Despite universal access to combined antiretroviral therapy in Brazil, substantial inequalities persist in the HIV\/AIDS epidemic. This nationwide retrospective study analyzed 753,071 notifications from the Brazilian Notifiable Diseases Information System (SINAN) between 2014 and 2024 to characterize the epidemiological profile, temporal trends, spatial distribution, factors associated with AIDS-stage notification, and predictors of AIDS-related mortality. HIV infection notifications accounted for 491,976 records, while AIDS case notifications accounted for 261,095. HIV infection notifications were concentrated among young adults, particularly men aged 20\u201329 years, whereas AIDS case notifications were more frequent in older age groups. Spatial analysis showed significant positive autocorrelation of smoothed municipal notification rates (Moran\u2019s I\u2009=\u20090.2306;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), with significant High-High clusters mainly in the South and Southeast regions. In the multivariable logistic regression model, older age was strongly associated with AIDS-stage notification, reaching the highest odds among individuals aged 60 years or older (AOR\u2009=\u20092.03; 95% CI: 1.96\u20132.09), while higher education was associated with lower odds. In the Cox model, age at diagnosis was the main predictor of mortality, with increased risk among individuals aged 30\u201349 years (AHR\u2009=\u20091.42; 95% CI: 1.36\u20131.49) and 50 years or older (AHR\u2009=\u20091.95; 95% CI: 1.86\u20132.05). Lower education and injecting drug use were also strongly associated with AIDS-related mortality. These findings indicate that, although AIDS case notifications have declined over time, AIDS-stage notification and mortality remain concentrated in socially and geographically vulnerable groups.\n                  <\/jats:p>","DOI":"10.1007\/s10900-026-01614-6","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T08:40:00Z","timestamp":1786005600000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Epidemiological Profile, Spatial Dynamics, and Survival Outcomes of HIV\/AIDS Patients in Brazil (2014\u20132024): A Nationwide Study of AIDS-stage Notification and Mortality"],"prefix":"10.1007","author":[{"given":"Bruno","family":"Almeida-Silva","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudeir Dias","family":"da Silva-Junior","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald Rodrigues","family":"de Moura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia Pereira","family":"da Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno Rodrigo","family":"Assun\u00e7\u00e3o","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Houemakou Rimaud","family":"Djidonou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"1614_CR1","unstructured":"WHO guidelines on the. (2025). management of advanced HIV disease. World Health Organization."},{"key":"1614_CR2","doi-asserted-by":"publisher","unstructured":"Jiang, Y., Su, S., & Born\u00e9, Y. A meta-analysis of the efficacy of HAART on HIV transmission and its impact on sexual risk behaviours among men who have sex with men. Scientific Reports 2020;10. https:\/\/doi.org\/10.1038\/s41598-019-56530-8","DOI":"10.1038\/s41598-019-56530-8"},{"issue":"2","key":"1614_CR3","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1590\/S1020-49892012000800005","volume":"32","author":"SMG Rossi","year":"2012","unstructured":"Rossi, S. M. G., Maluf, E. C. P., Carvalho, D. S., Ribeiro, C. E. L., & Battaglin, C. R. P. (2012). Impacto da terapia antirretroviral conforme diferentes consensos de tratamento da Aids no Brasil. Revista Panamericana De Salud Publica, 32(2), 117\u2013123.","journal-title":"Revista Panamericana De Salud Publica"},{"key":"1614_CR4","doi-asserted-by":"publisher","first-page":"e90","DOI":"10.7717\/peerj.90","volume":"1","author":"G Alvarez-Uria","year":"2013","unstructured":"Alvarez-Uria, G. (2013). Factors associated with delayed entry into HIV medical care after HIV diagnosis in a resource-limited setting: Data from a cohort study in India. PeerJ, 1, e90. https:\/\/doi.org\/10.7717\/peerj.90","journal-title":"PeerJ"},{"key":"1614_CR5","doi-asserted-by":"publisher","first-page":"e19636","DOI":"10.25248\/reas.e19636.2025","volume":"25","author":"W Carvalho Filho","year":"2025","unstructured":"Carvalho Filho, W., Santos, L., de Ribeiro, S., Menezes, B. S., de FS, L., Justo, C. M., Sarmento, L. A., et al. (2025). Mortalidade por AIDS no Brasil: diferentes tend\u00eancias em um pa\u00eds continental. Revista Eletr\u00f4nica Acervo Sa\u00fade, 25, e19636. https:\/\/doi.org\/10.25248\/reas.e19636.2025","journal-title":"Revista Eletr\u00f4nica Acervo Sa\u00fade"},{"key":"1614_CR6","doi-asserted-by":"publisher","first-page":"895","DOI":"10.1590\/1413-81232022273.00432021","volume":"27","author":"AP da Cunha","year":"2022","unstructured":"da Cunha, A. P., da Cruz, M. M., & Pedroso, M. (2022). Analysis of the trend of mortality from HIV\/AIDS according to sociodemographic characteristics in Brazil, 2000 to 2018. Ciencia e Saude Coletiva, 27, 895\u2013908. https:\/\/doi.org\/10.1590\/1413-81232022273.00432021","journal-title":"Ciencia e Saude Coletiva"},{"key":"1614_CR7","doi-asserted-by":"publisher","first-page":"e9980","DOI":"10.25248\/reas.e9980.2022","volume":"15","author":"L de Castro","year":"2022","unstructured":"de Castro, L., Luz, A. S., de Sousa, T. V., Pinheiro, T. S., Gomes, F. E. V., Sousa, S. R. R., et al. (2022). Epidemiologia da mortalidade pelo HIV\/AIDS no Brasil entre os anos de 2016 e 2021: uma revis\u00e3o integrativa. Revista Eletr\u00f4nica Acervo Sa\u00fade, 15, e9980. https:\/\/doi.org\/10.25248\/reas.e9980.2022","journal-title":"Revista Eletr\u00f4nica Acervo Sa\u00fade"},{"key":"1614_CR8","doi-asserted-by":"publisher","first-page":"4599","DOI":"10.1590\/1413-812320182412.25542019","volume":"24","author":"R Agostini","year":"2019","unstructured":"Agostini, R., Rocha, F., Melo, E., & Maksud, I. (2019). A resposta brasileira \u00e0 epidemia de HIV\/AIDS em tempos de crise. Cien Saude Colet, 24, 4599\u20134604. https:\/\/doi.org\/10.1590\/1413-812320182412.25542019","journal-title":"Cien Saude Colet"},{"key":"1614_CR9","doi-asserted-by":"publisher","DOI":"10.1007\/s10900-026-01590-x","author":"HF Lopes-Araujo","year":"2026","unstructured":"Lopes-Araujo, H. F., Guedes, M. C. S., Carvalho-Silva, W. H. V., & Guimar\u00e3es, R. L. (2026). The HIV\/AIDS Epidemiological Challenges: Why is HIV Incidence Rising While AIDS Incidence and Mortality are Declining in Brazil? Journal Of Community Health. https:\/\/doi.org\/10.1007\/s10900-026-01590-x","journal-title":"Journal Of Community Health"},{"key":"1614_CR10","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1007\/s10461-023-04139-4","volume":"28","author":"W Mude","year":"2024","unstructured":"Mude, W., Mwenyango, H., Preston, R., O\u2019Mullan, C., Vaughan, G., & Jones, G. (2024). HIV Testing Disruptions and Service Adaptations During the COVID-19 Pandemic: A Systematic Literature Review. Aids And Behavior, 28, 186\u2013200. https:\/\/doi.org\/10.1007\/s10461-023-04139-4","journal-title":"Aids And Behavior"},{"key":"1614_CR11","doi-asserted-by":"publisher","first-page":"2629","DOI":"10.1007\/s10461-023-03988-3","volume":"27","author":"AE Bocage","year":"2023","unstructured":"Bocage, A. E., Coelho, L. E., Lake, J. E., Clark, J. L., Torres, T. S., Jalil, E. M., et al. (2023). The Impact of COVID-19 on HIV Care in Rio de Janeiro, Brazil 2019\u20132021: Disparities by Age and Gender. Aids And Behavior, 27, 2629\u20132641. https:\/\/doi.org\/10.1007\/s10461-023-03988-3","journal-title":"Aids And Behavior"},{"key":"1614_CR12","doi-asserted-by":"crossref","unstructured":"Jalil, C. M., Teixeira, S. L. M., Coutinho, C., Nazer, S. C., Carvalheira, E., Hoagland, B. (2024). Impact of COVID-19 Pandemic on HIV Testing, Recent Infections, and Annualized Incidence Among Cisgender Men Who Have Sex With Men and Transgender Women in Brazil.","DOI":"10.1097\/QAI.0000000000003531"},{"key":"1614_CR13","doi-asserted-by":"publisher","first-page":"467","DOI":"10.5123\/S1679-49742016000300003","volume":"25","author":"AIA de Sousa","year":"2016","unstructured":"de Sousa, A. I. A., & Pinto, V. L. (2016). An\u00e1lise espacial e temporal dos casos de aids no Brasil em 1996\u20132011: \u00e1reas de risco aumentado ao longo do tempo. Epidemiol Serv Saude, 25, 467\u2013476. https:\/\/doi.org\/10.5123\/S1679-49742016000300003","journal-title":"Epidemiol Serv Saude"},{"key":"1614_CR14","doi-asserted-by":"publisher","unstructured":"Batista, J. F. C., Oliveira, M. R., Pereira, D. L. M., Matos, M. L. S., da Souza, S., & Menezes, I. T. MO. Spatial distribution and temporal trends of AIDS in Brazil and regions between 2005 and 2020. Revista Brasileira de Epidemiologia 2023;26. https:\/\/doi.org\/10.1590\/1980-549720230002","DOI":"10.1590\/1980-549720230002"},{"key":"1614_CR15","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1590\/1980-5497201600020004","volume":"19","author":"S Brignol","year":"2016","unstructured":"Brignol, S., Kerr, L., Amorim, L. D., & Dourado, I. (2016). Fatores associados a infec\u00e7\u00e3o por HIV numa amostra respondent-driven sampling de homens que fazem sexo com homens, Salvador. Revista Brasileira de Epidemiologia, 19, 256\u2013271. https:\/\/doi.org\/10.1590\/1980-5497201600020004","journal-title":"Revista Brasileira de Epidemiologia"},{"key":"1614_CR16","doi-asserted-by":"publisher","unstructured":"MacCarthy, S., Brignol, S., Reddy, M., Nunn, A., & Dourado, I. (2016). Late presentation to HIV\/AIDS care in Brazil among men who self-identify as heterosexual. Revista De Saude Publica, 50. https:\/\/doi.org\/10.1590\/S1518-8787.2016050006352","DOI":"10.1590\/S1518-8787.2016050006352"},{"key":"1614_CR17","doi-asserted-by":"publisher","unstructured":"Grangeiro, A., Escuder, M. M., Cassanote, A. J. F., Souza, R. A., Kalichman, A. O., Veloso, V., et al. (2014). The HIV-Brazil Cohort study: Design, methods and participant characteristics. PLoS One, 9. https:\/\/doi.org\/10.1371\/journal.pone.0095673","DOI":"10.1371\/journal.pone.0095673"},{"key":"1614_CR18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1590\/1518-8345.4072.3342","volume":"28","author":"LCS Ribeiro","year":"2020","unstructured":"Ribeiro, L. C. S., Freitas, M. I., de Tupinamb\u00e1s, F., & Lana, U. (2020). Late diagnosis of human immunodeficiency virus infection and associated factors. Rev Lat Am Enfermagem, 28, 1\u201312. https:\/\/doi.org\/10.1590\/1518-8345.4072.3342","journal-title":"Rev Lat Am Enfermagem"},{"key":"1614_CR19","doi-asserted-by":"publisher","unstructured":"Ke, S., Fang, Q., Lan, J., Qiao, N., Zhang, X., Xie, C. Survival times of HIV\/AIDS in different AIDS Diagnostic and Treatment Guidelines from 2006 to 2020 in Liuzhou, China. Bmc Public Health 2023;23. https:\/\/doi.org\/10.1186\/s12889-023-15662-3","DOI":"10.1186\/s12889-023-15662-3"},{"key":"1614_CR20","doi-asserted-by":"publisher","unstructured":"Arantes, L. M. N., Pedroso, A. O., Menegueti, M. G., Gir, E., Botelho, E. P., & de Silva, A. C. O e., et al. Factors Associated with Late Diagnosis of Human Immunodeficiency Virus\/Acquired Immunodeficiency Syndrome (HIV\/AIDS) in a University Hospital in Brazil: Challenges to Achieving the 2030 Target. Viruses 2023;15. https:\/\/doi.org\/10.3390\/v15102097","DOI":"10.3390\/v15102097"},{"key":"1614_CR21","doi-asserted-by":"publisher","unstructured":"Melo, E. A., Maksud, I., Agostini, R., & Cuidado HIV\/Aids e aten\u00e7\u00e3o prim\u00e1ria no Brasil: desafio para a aten\u00e7\u00e3o no Sistema \u00danico de Sa\u00fade? Revista Panamericana de Salud P\u00fablica 2018;42. https:\/\/doi.org\/10.26633\/RPSP.2018.151","DOI":"10.26633\/RPSP.2018.151"},{"key":"1614_CR22","doi-asserted-by":"publisher","unstructured":"Dourado, I., Magno, L., Greco, D. B., & Grangeiro, A. (2023). Combination HIV prevention for adolescent men who have sex with men and adolescent transgender women in Brazil: vulnerabilities, access to healthcare, and expansion of PrEP. Cad Saude Publica, 39. https:\/\/doi.org\/10.1590\/0102-311xen228122","DOI":"10.1590\/0102-311xen228122"},{"key":"1614_CR23","doi-asserted-by":"publisher","first-page":"982","DOI":"10.1111\/hiv.70023","volume":"26","author":"J Zhao","year":"2025","unstructured":"Zhao, J., Gao, M., Zhao, D., & Tian, W. (2025). Prevalence of late HIV diagnosis and its impact on mortality: A comprehensive systematic review and meta-analysis. Hiv Medicine, 26, 982\u2013992. https:\/\/doi.org\/10.1111\/hiv.70023","journal-title":"Hiv Medicine"},{"key":"1614_CR24","doi-asserted-by":"publisher","first-page":"e0219689","DOI":"10.1371\/journal.pone.0219689","volume":"14","author":"D Gao","year":"2019","unstructured":"Gao, D., Zou, Z., Dong, B., Zhang, W., Chen, T., Cui, W., et al. (2019). Secular trends in HIV\/AIDS mortality in China from 1990 to 2016: Gender disparities. PLoS One, 14, e0219689. https:\/\/doi.org\/10.1371\/journal.pone.0219689","journal-title":"PLoS One"}],"container-title":["Journal of Community Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10900-026-01614-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10900-026-01614-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10900-026-01614-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T08:40:03Z","timestamp":1786005603000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10900-026-01614-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,6]]},"references-count":24,"alternative-id":["1614"],"URL":"https:\/\/doi.org\/10.1007\/s10900-026-01614-6","relation":{},"ISSN":["0094-5145","1573-3610"],"issn-type":[{"value":"0094-5145","type":"print"},{"value":"1573-3610","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,6]]},"assertion":[{"value":"8 July 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 August 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare that they have no competing interests.","order":1,"name":"Ethics","label":"Competing Interests","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethics approval and informed consent were not required because this study used publicly available, de-identified secondary data from DATASUS\/SINAN.","order":2,"name":"Ethics","label":"Ethics Approval and Consent to Participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":3,"name":"Ethics","label":"Consent for Publication","group":{"name":"EthicsHeading","label":"Declarations"}}]}}