AIDS in the Brazilian Amazon: epidemiological trends and disparities across states

Acquired Immunodeficiency Syndrome (AIDS), caused by the Human Immunodeficiency Virus (HIV), remains a major public health problem in Brazil. Infection rates vary greatly between regions and states. The North region, in particular, has a higher number of cases, making it a long-lasting challenge, especially in a region with many social and economic challenges. This ecological, descriptive, and analytical study examined AIDS trends across Northern Brazilian states from 2013 to 2023 using data from Brazil's Notifiable Diseases Information System (SINAN), Mortality Information System (SIM) and national HIV/AIDS epidemiological reports. Our R-based analytical approach incorporated descriptive statistics, Joinpoint regression, linear modeling (calculating trend coefficients, determination coefficients, and p-values with significance at p < 0.05), plus heatmap clustering with dendrograms to evaluate inter-state rate patterns. Spatial variation analysis revealed distinct epidemiological patterns: four states (Amazonas, Amapá, Tocantins, and Rondônia) showed declining detection rates, while Acre experienced a concerning >90% increase despite stable mortality rates. These findings emphasize important groups of cases and identify which states should prioritize public health efforts. This information can assist in more effectively allocating resources to areas with the most cases.