Areas of vulnerability to HIV/TB co-infection in Southeastern Brazil.

OBJECTIVE To identify areas of vulnerability to new cases of HIV/tuberculosis (TB) co-infection. METHODS An ecological descriptive study was conducted by georeferencing new HIV/TB cases reported in the city of Ribeirão Preto, Southeastern Brazil, in 2006. Data were obtained from the São Paulo state information system for TB notification (TB-WEB) database. New cases of HIV/TB co-infection were analyzed according to sociodemographic and clinical characteristics and, subsequently, georeferenced in the city's cartographic basis, based on home addresses. City sectors were categorized into three socioeconomic levels: lower, average and upper levels, based on the analysis of the main components of the 2000 Demographic Census variables (income, level of education and percentage of households with five or more residents). The incidence of HIV/TB co-infection was calculated for each socioeconomic level. RESULTS HIV/TB co-infection affected a higher number of economically active adult males and the pulmonary form of TB was the most frequent. Spatial distribution showed that the incidences in areas with average and lower socioeconomic levels (8.3 and 11.5 cases per 100,000 inhabitants, respectively) were higher than that with a higher socioeconomic level (4.8 cases per 100,000 inhabitants). CONCLUSIONS The incidence rate of HIV/TB co-infection, analyzed according to socioeconomic levels, showed a non-homogeneous spatial pattern of distribution and higher values in more socially vulnerable areas. The present study identified priority geographical areas to control co-infection and revealed that the geographical information system technology can be used by city managers to plan health actions.