Inequalities in the provision of rapid HIV testing in primary health care: ecological study, Paraná, 2013-2023.
- 1Secretaria Municipal de Saúde, Gerência de Planejamento, Maringá, PR, Brazil.
- 2Universidade Estadual de Maringá, Departamento de Enfermagem, Maringá, PR, Brazil.
- 3Universidade Federal do Vale do São Francisco, Colegiado de Medicina, Paulo Afonso, BA, Brazil.
Abstract
Objective
To analyze temporal trends, spatial distributions, and factors associated with the provision of rapid HIV testing in primary health care in Paraná, between 2013 and 2023.Methods
Ecological study using data from the Outpatient Information System (Sistema de Informações Ambulatoriais, SIA) on the provision of rapid HIV testing. Testing rates per 10,000 inhabitants were calculated, and temporal trends were analyzed using joinpoint regression. Spatial distribution was performed at the municipal level, and the rates were tested against 17 socioeconomic and programmatic indicators using negative binomial regression.Results
During the period, 385,960 tests were recorded, of which 89.1% were performed by nurses. The state mean was 30.79 tests per 10,000 inhabitants, with emphasis on the Western macroregion (86.66 per 10,000 inhabitants). Some regions, such as Cornélio Procópio, showed marked growth (annual percentage change [APC] 71.19; 95% confidence interval [95%CI] 55.54; 205.09). Spatial analysis indicated a concentration of municipalities with higher testing rates in the Pato Branco, Francisco Beltrão, and Foz do Iguaçu regions. The illiteracy rate (rate ratio [RR] 0.77; 95%CI 0.63; 0.93), prenatal care coverage (RR 1.20; 95%CI 1.04; 1.37), and detection of acquired syphilis (RR 1.33; 95%CI 1.11; 1.59) were associated with the provision of rapid testing.Conclusion
Testing showed growth over the study period, though uneven across regions and marked by municipal heterogeneity. Socioeconomic, epidemiological, and programmatic factors influenced performance, indicating the need for targeted policies to reduce inequalities and strengthen primary health care in HIV diagnosis.
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BibTeX
@article{lima2026inequalities,
title = {{Inequalities in the provision of rapid HIV testing in primary health care: ecological study, Paraná, 2013-2023.}},
author = {Lucas Vinícius de Lima and Gabriel Pavinati and Márcia Moroskoski and Nelly Lopes de Moraes Gil and Iukary Oliveira Takenami and Gabriela Tavares Magnabosco},
journal = {Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil},
year = {2026},
month = oct,
doi = {10.1590/s2237-96222026v35e20250981.en},
url = {https://europepmc.org/article/MED/42903047},
note = {CC BY},
}
RIS
TY - JOUR
TI - Inequalities in the provision of rapid HIV testing in primary health care: ecological study, Paraná, 2013-2023.
AU - Lucas Vinícius de Lima
AU - Gabriel Pavinati
AU - Márcia Moroskoski
AU - Nelly Lopes de Moraes Gil
AU - Iukary Oliveira Takenami
AU - Gabriela Tavares Magnabosco
PY - 2026
DA - 2026/10/12
JO - Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil
DO - 10.1590/s2237-96222026v35e20250981.en
UR - https://europepmc.org/article/MED/42903047
AB - Objective To analyze temporal trends, spatial distributions, and factors associated with the provision of rapid HIV testing in primary health care in Paraná, between 2013 and 2023.Methods Ecological study using data from the Outpatient Information System (Sistema de Informações Ambulatoriais, SIA) on the provision of rapid HIV testing. Testing rates per 10,000 inhabitants were calculated, and temporal trends were analyzed using joinpoint regression. Spatial distribution was performed at the municipal level, and the rates were tested against 17 socioeconomic and programmatic indicators using negative binomial regression.Results During the period, 385,960 tests were recorded, of which 89.1% were performed by nurses. The state mean was 30.79 tests per 10,000 inhabitants, with emphasis on the Western macroregion (86.66 per 10,000 inhabitants). Some regions, such as Cornélio Procópio, showed marked growth (annual percentage change [APC] 71.19; 95% confidence interval [95%CI] 55.54; 205.09). Spatial analysis indicated a concentration of municipalities with higher testing rates in the Pato Branco, Francisco Beltrão, and Foz do Iguaçu regions. The illiteracy rate (rate ratio [RR] 0.77; 95%CI 0.63; 0.93), prenatal care coverage (RR 1.20; 95%CI 1.04; 1.37), and detection of acquired syphilis (RR 1.33; 95%CI 1.11; 1.59) were associated with the provision of rapid testing.Conclusion Testing showed growth over the study period, though uneven across regions and marked by municipal heterogeneity. Socioeconomic, epidemiological, and programmatic factors influenced performance, indicating the need for targeted policies to reduce inequalities and strengthen primary health care in HIV diagnosis.
SN - 1679-4974
SN - 2237-9622
ER -