       Document 2577
 DOCN  M94A2577
 TI    Heterogeneity of HIV epidemic in the Italian regions.
 DT    9412
 AU    Cantoni M; Grossi P; Mariotto A; Verdecchia A; Istituto Superiore di
       Sanita, Roma, Italy.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):272 (abstract no. PC0009). Unique
       Identifier : AIDSLINE ICA10/94369998
 AB    OBJECTIVE: The AIDS epidemic, as with any infectious disease epidemics,
       encloses clusters of subepidemics separated geographically. The
       objective is to characterize the Italian AIDS epidemic into regional
       subepidemics and highlight any differences in order to adopt more
       efficient local prevention and health care strategies. METHOD: To
       compare the regional patterns of the epidemic, standardized AIDS rates,
       with reference to the regional population by age, were estimated for
       each calendar year (1983-1993), region and risk group. RESULTS: As a
       first regional division of the AIDS epidemic in Italy, the country could
       be divided into the North-Central region, which has a high incidence
       rate and prevalence, and the Southern region where the epidemic is at
       lower levels. However, in the North-Central region, the epidemic is not
       uniformly distributed, the highest incidence rates in 1992 being
       localized around large towns: Milan and surroundings (15 per 100,000)
       and Rome (13 per 100,000) and the harbour towns: Genoa (18 per 100,000),
       Livorno (13 per 100,000) and Cagliari (on the island of Sardegna) (12
       per 100,000). There is heterogeneity however, with respect to ways of
       transmission. In the above-mentioned, high incidence regions, the
       epidemic occurs mainly between IVDU's: Cagliari (73%), Genoa (69%),
       Milan (63%) and Roma (61%), whereas in some of the lower-incidence
       regions the epidemic is characterized by having a considerable number of
       homosexuals cases, for example, in the Toscany region with an AIDS
       incidence rate of 7 per 100,000 about 40% are homosexuals. Among
       heterosexuals the AIDS epidemic is at relatively low levels in Italy
       (about 1 per 100,000), with the exception of Rimini, a turistic, sea
       resort, where this group represents 21% of all local AIDS cases with an
       incidence rate of 4 per 100,000 by far the largest in the country.
       CONCLUSIONS AND DISCUSSION: The method allows the comparison of rates
       rather than counts which is important since, for example, the small
       number of AIDS cases in Sardegna would not in itself indicate a high
       incidence rate, as it does when referred to its small population. This
       method can correctly assess the importance of the epidemic in the
       different groups. As a consequence of the heterogeneity the course of
       the epidemic in each area is expected to continue at different rates.
 DE    Acquired Immunodeficiency Syndrome/*EPIDEMIOLOGY/TRANSMISSION  *Disease
       Outbreaks  Human  Incidence  Italy/EPIDEMIOLOGY  Risk Factors  Sex
       Behavior  Substance Abuse, Intravenous/COMPLICATIONS  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

