[Acquired immunodeficiency syndrome in Brazil and the State of Ceará]

Since February 1998, a total of 129,000 cases of acquired immune deficiency syndrome have been reported in Brazil. The cumulative frequency of the disease is 82 per 100,000 which makes Brazil one of the countries moderately affected. There are considerable differences between regions in the frequency of cases, from 25 per 100,000 in the north and north east to 152 per 100,000 in the south east. Sexual intercourse is still the predominant means of transmission. Transmission in the early years of the epidemic was mostly between homosexuals and bisexuals, but transmission via heterosexual intercourse is increasing. The contribution made by intravenous drug use differs between the regions, and is particularly large in the mid-south region. A pilot project in the city of Fortaleza has shown that it is possible to successfully integrate the diagnosis of STD and AIDS in health care units at an intermediate level. This appears to be an appropriate strategy for the integration of STD treatment into primary health care in Ceará State. The non-uniform pattern of development of this epidemic must be taken into account in epidemiological analyses of AIDS in Brazil.