AIDS and HIV infection in Brazil: a multifaceted epidemic

A epidemia da infec????o pelo HIV e da AIDS constitui fen??meno global, din??mico e inst??vel, traduzindo-se por verdadeiro mosaico de sub-epidemias regionais. Resultante das profundas desigualdades da sociedade brasileira, a propaga????o da infec????o pelo HIV e da AIDS revela epidemia de m??ltiplas dimens??es que vem sofrendo transforma????es epidemiol??gicas significativas. Inicialmente restrita aos grandes centros urbanos e marcadamente masculina, a atual epidemia do HIV e da AIDS caracteriza-se pelos processos de heterossexualiza????o, feminiza????o, interioriza????o e pauperiza????o. As mudan??as no perfil da AIDS no Brasil devem-se ?? difus??o geogr??fica da doen??a a partir dos grandes centros urbanos em dire????o aos munic??pios de m??dio e pequeno porte, ao aumento da transmiss??o por via heterossexual e ao persistente crescimento dos casos entre usu??rios de drogas injet??veis. O aumento da transmiss??o por contato heterossexual implica no crescimento substancial de casos em mulheres, o qual tem sido apontado como uma das mais importantes caracter??sticas do atual quadro da epidemia no Brasil.The HIV/AIDS epidemic is a dynamic unstable global phenomenon, constituting a veritable mosaic of regional sub-epidemics. As a consequence of the deep inequalities that exist in Brazilian society, the spread of HIV infection has revealed an epidemic of multiple dimensions undergoing extensive epidemiological transformations. Initially restricted to large urban centers and markedly masculine, the HIV/AIDS epidemic is currently characterized by heterosexualization, feminization, interiorization and pauperization. The evolution of the profile of AIDS in Brazil is above all due to the geographical diffusion of the disease from large urban centers towards medium and small municipalities in the interior, to the increase in heterosexual transmission and the persistent growth of cases among injecting drug users. The increase in transmission through heterosexual contact has resulted in substantial growth of cases among women, which has been pointed out as the most important characteristic of the epidemic???s current dynamic in Brazil