According to a ranking published by the Ministry of Health on Thursday (30), Lages in Serra Santa Catarina is the worst municipality in Brazil in terms of AIDS and HIV treatment. The classification takes into account the cross-reference of data: disease detection rates, mortality, morbidity among children under 5 years of age and diagnosis.

Lajes has the worst aggregate index of all Brazilian cities with a population of more than 100 thousand people – Photo: Archive/Marcelo Camargo/Agência Brasil/Reproduction/ND

The epidemiological bulletin was released by the Ministry of Health on Thursday (30), the eve of ‘World AIDS Day’, which kicks off ‘Red December’, a month dedicated to raising awareness of the disease.

Two Santa Catarina cities are in the top 10 rankings

The index of 7.228 places Lages 1st out of the 100 municipalities with a population of over 100,000 with the highest aggregate index. Besides Lages, Florianópolis ranks 9th with 6,311 players.

Regina Walim, infectious disease doctor and manager of sexually transmitted infections surveillance at Dive/SC (Santa Catarina Epidemiological Surveillance Directorate), explained that the ranking determines the situation in the municipality.

“The closer to the 100th position, the better the epidemiological situation in this municipality, but it is advisable [o município] not to be part of this rating,” he notes.

The ranking takes into account the average of seven AIDS-related indicators:

• Detection rate among the general population over the past three years
• Average annual change in detection rate in the general population over the past five years
• Mortality rate of the general population over the past three years
• Average annual mortality rate for the population as a whole over the past five years
• Detection rate in children under 5 years of age in children under 5 years of age over the past three years
• Average annual rate of detection in children under 5 years of age over the past five years
• Average first CD4 (level of immunological vulnerability at diagnosis)

The doctor explains that the CD4 level determines whether the diagnosis of HIV will be made late or not.

“CD4 is an immune cell that is attacked by the virus; the virus receptor binds to CD4. But CD4 is one of the main cells in our immune system, so the lower the CD4 level, the lower the CD4 level. [a contagem]the worse the person’s situation,” he explains.

According to Regina, the ideal time for diagnosis is when a person with HIV has a CD4 count above 500. When the count is below 200, the person is more vulnerable to opportunistic diseases, and therefore to AIDS.

The average CD4 count among people with HIV at diagnosis is 299 in Lages and 399 in Florianópolis.

See the bets that brought Lages to 1st place in the rankings

The composite index is formed by averaging seven indicators – Photo: ND

Position in the ranking triggers a warning for municipalities

According to Regina, the position in the ranking means that the municipality and the state must strengthen measures for the prevention, diagnosis and treatment of the disease.

“There are several points in which the municipality and, of course, the state will have to take measures to improve: diagnosis, monitoring of these people, preventing interruption of treatment, offering testing,” he listed.

Treatment of HIV and AIDS

People living with HIV can start treatment and receive routine care in health centers and hospitals from appropriately qualified doctors and nurses. A person newly diagnosed with HIV can begin treatment on the same day.

What Lages and Florianopolis say

Lages said it received the “Silver Seal of Best Practice for Eliminating Vertical Transmission of HIV” from the Ministry of Health for reducing cases between 2020 and 2021.

Florianópolis said the composite index was affected by rising cases among pregnant women and children under 5 years of age. However, the mayor’s office reported that between 2019 and 2022 there was a reduction in new HIV cases by more than 20% and AIDS cases by more than 26%.

Among the measures, the city of Florianópolis specifies that it carries out extensive educational work among professionals and the population on HIV testing and detection in CTRs (testing and rapid response centers, one in each clinic) for the treatment of the disease and prenatal monitoring, in addition to offering self-testing for HIV.

Residents of Florianópolis can also request an HIV self-test through the website www.ahoraeagora.org. Tests can be obtained by mail, collected from the digital office located at the Rita Maria bus station, or from medical institutions.