42973 - EFFECT OF A CONDITIONAL CASH TRANSFER ON AIDS INCIDENCE, HOSPITALIZATIONS AND MORTALITY IN BRAZIL: A NATIONWIDE LONGITUDINAL STUDY
GABRIEL ALVES DE SAMPAIO MORAIS - COLLECTIVE HEALTH INSTITUTE, FEDERAL UNIVERSITY OF BAHIA, SALVADOR, BRAZIL, LAIO MAGNO - UNIVERSITY OF THE STATE OF BAHIA, LIFE SCIENCE DEPARTMENT, ANDREA FERREIRA SILVA - COLLECTIVE HEALTH INSTITUTE, FEDERAL UNIVERSITY OF BAHIA, SALVADOR, BRAZIL, NATHALIA S GUIMARÃES - COLLECTIVE HEALTH INSTITUTE, FEDERAL UNIVERSITY OF BAHIA, SALVADOR, BRAZIL, JOSÉ ALEJANDRO ORDOÑEZ - COLLECTIVE HEALTH INSTITUTE, FEDERAL UNIVERSITY OF BAHIA, SALVADOR, BRAZIL, LUÍS EUGÊNIO SOUZA - COLLECTIVE HEALTH INSTITUTE, FEDERAL UNIVERSITY OF BAHIA, SALVADOR, BRAZIL, JAMES MACINKO - UNIVERSITY OF CALIFORNIA AT LOS ANGELES (UCLA), UCLA FIELDING SCHOOL OF PUBLIC HEALTH, LOS ANGELES, USA, INÊS DOURADO - COLLECTIVE HEALTH INSTITUTE, FEDERAL UNIVERSITY OF BAHIA, SALVADOR, BRAZIL, DAVIDE RASELLA - ISGLOBAL, HOSPITAL CLÍNIC - UNIVERSITAT DE BARCELONA, BARCELONA, SPAIN
Apresentação/Introdução
Brazil has long been recognized for its strong response to the AIDS epidemic. However, one of the biggest challenges of this response has been reaching the poorest people. The country implemented one of the world’s largest Conditional Cash Transfer programmes, the Bolsa Familia Programme (BFP), which targeted poor individuals and contributed to the improvement of their socioeconomic conditions.
Objetivos
The study aims to estimate the effect between BFP coverage levels and AIDS incidence, hospitalization and mortality rates over the period 2004-2018 in Brazil. Also, we investigated the effect on adult women and men, and children up to 14 years old
Metodologia
This ecological study used panel data from 5,507 Brazilian municipalities over the period 2004 to 2018 and fixed effects multivariable negative binomial regressions to estimate the effect of BFP coverage - classified as low (0% to 29%), intermediate (30% to 69%), and high (≥70%) - on the main AIDS outcomes (i.e., incidence, hospitalizations and mortality rates) while adjusting for all relevant demographic, socioeconomic and healthcare covariates at municipal level.
Resultados
A high BFP coverage associated with reduction of AIDS incidence (Rate Ratio – RR:0.94; 95%CI:0.90-0.99), AIDS-related hospitalizations (RR:0.85; 95%CI:0.79-0.92) and AIDS mortality rates (RR:0.88; 95%CI:0.81-0.94). The effect on AIDS incidence was more pronounced in municipalities with higher AIDS endemicity levels (RR:0.87; 95%CI:0.80-0.94), among adult women (RR:0.85; 95%CI:0.77-0.94) and in children up to 14 years old (RR:0.75; 95%CI:0.57-0.99).
Conclusões/Considerações
The first study to comprehensively evaluate the effect of a CCT on AIDS in a LMIC. The effect of BFP on AIDS outcomes in Brazil could be explained by the reduction of households’ poverty and by BFP health-related conditionalities. During the current rise in global poverty due to the COVID-19 pandemic, the protection of the most vulnerable populations through conditional cash transfers could avert potential changes in the trends of AIDS in LMIC.
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