The number of deaths of people with HIV from tuberculosis rises – 04/16/2023 – Health

Tuberculosis remains the main cause of death for people with HIV in Brazil. In 2021, there were 284 deaths, an increase of 20.3% compared to 2020 and 2.2% compared to 2019, pre-Covid pandemic, according to data from the Ministry of Health.

Also considering 2021, the disease accounted for 1 in 3 deaths of people with the virus.

The ministry’s indicators point out that in 2022 there was a reduction in the number of HIV tests and, with that, the registered number of co-infection of tuberculosis and the virus decreased. In addition, it was the year with the highest percentage of cure reduction for the disease in this public.

Experts point out that the worsening of the indicators has several reasons, such as the difficulty in accessing treatment and the restriction of health expenses after the creation of the spending cap, which came into effect in 2017.

In all, in 2021, the country recorded 5,072 deaths from tuberculosis, up 11% compared to the previous year (4,569).

The sum of new diagnoses has also been rising. Last year, it reached 78,057 (36.3 per 100,000 inhabitants), surpassing the 74,385 (34.9 per 100,000 inhabitants) and 70,554 (33.3 per 100,000 inhabitants) of 2021 and 2020, respectively.

The disease appears among the most deadly infectious diseases in the world, second only to Covid. Transmission takes place via the respiratory route, through the elimination of aerosols produced by the cough, speech or sneeze of a person with the active disease.

The Global Strategy for AIDS (syndrome caused by HIV) from 2021 to 2026 has as a goal that 95% of people living with HIV are undergoing preventive treatment for tuberculosis, a goal assumed by Brazil at the UN (United Nations) in June 2021.

Claudia Velasquez, director and representative of Unaids (Joint United Nations Program on HIV/AIDS) in Brazil, said that Covid also had an impact in relation to the interruption of treatment and an increase in deaths, as it limited access to services and health monitoring. .

The director explains that, among people living with HIV, this impact is devastating because it determines the individual’s survival.

According to her, the disease caused by the bacteria Mycobacterium tuberculosis advances in this public driven by stigmas and biomedical issues. HIV weakens the immune system and, when tuberculosis arrives, the effect of co-infection makes the weakening faster.

Another point is the inequality that limits access to the service. The cost of public transport, for example, can be a social and structural barrier to accessing the health service and, consequently, the treatment, offered by the public network 100% free of charge and lasting at least six months.

“Discrimination against people living with HIV or AIDS is a barrier to treatment. We know that, in practice, care for the diagnosed person goes through health units that are not always prepared to serve them”, says Velasquez.

Maria Elias Silveira, 45, has been living with HIV for 22 years and has already been diagnosed with tuberculosis in 2006 and 2022. Still undergoing treatment, the sex worker says she had to return to the streets for financial reasons.

For her, even with doctors recommending rest, there are issues that prevent this from happening in her routine in Belém, Pará.

“I don’t have a proper lunch break, I make my own schedule and I don’t rest. When I had four months of treatment for tuberculosis, I went out to work even though I was worried about my health, but the financial situation worried me much more.”

Silveira says that there are people with difficulty accessing treatment immediately because of the region in which they live and also that some health professionals lack acceptance. “Doctors sometimes do not respond as they should, once they asked me why I had tuberculosis again.”

Infectologist and professor at UnB (University of Brasilia) Jonas Brant says that the space conquered by conservative agendas in the public debate has harmed the fight against STIs (Sexually Transmitted Infections), such as HIV, and, consequently, related diseases.

“We saw a setback in this agenda because the retrograde and denialist agendas advanced a lot and made other agendas leave the focus of public administration.”

As an example, he cites sex education in schools. By not exposing how STIs are transmitted, the trend is for an increase in cases of infection, he explained.

The director of the Department of HIV/AIDS, Tuberculosis, Viral Hepatitis and Sexually Transmitted Infections of the Ministry of Health, Draurio Barreira, agrees that there was a drastic reduction in investment in social policies, with “deprioritization of social actions and work with vulnerable population”.

According to him, President Luiz Inácio Lula da Silva (PT) will sign a decree for the creation of an interministerial group involving seven ministries to tackle the elimination of tuberculosis by 2030 and other socially determined diseases.