BACKGROUND: The epidemiological trends of AIDS have been influenced by socio-cultural conditions. OBJECTIVE: To describe the development of AIDS morbidity and mortality among 15-49 year-old adults in the city of São Paulo, according to gender and homogeneous socio-economic areas, from 1994 to 2001. METHODS: The sources of data were the STD/AIDS Program and the Mortality Information Improvement Program of the city of São Paulo. Homogeneous areas were built through the Social Exclusion Map of the City: areas 1 and 2 (central and inclusion areas); areas 3, 4 and 5 (peripheral and exclusion areas). Rates per 100,000 and morbidity and mortality ratios between 1995 and 2001 were calculated taking 1994 as the reference year. RESULTS: a decreasing incidence in all areas was observed among men since 1998-1999, and in the first four areas during this period among women. The decrease in AIDS incidence and mortality in men was faster in area 2: ratio 2001/94=0.43 and 0.21, and slower in the exclusion areas. Among women, area 5 presented an increase in incidence at the end of the period (54%), and areas 3, 4 and 5 presented a slower decrease in mortality. DISCUSSION: The mortality pattern followed morbidity in men: the most central areas are the most affected, with a greater decrease in mortality, but with a trend toward "peripheralization". In women, a later increment of the AIDS epidemic in the peripheral direction was confirmed, as was a trend toward a decrease in mortality inversely proportional to social exclusion areas.
AIDS Acquired Immune Deficiency Syndrome; Ecological Study; Homogeneous Areas; Social Conditions
