Emerging evidence suggests that HIV incidence rates in Brazil, particularly among men, may be rising. Here we use Brazil’s integrated health systems data to develop a mathematical model, reproducing the complex surveillance systems and providing estimates of HIV incidence, number of people living with HIV (PLHIV), reporting rates and ART initiation rates.

An age-structured deterministic model with a flexible spline was used to describe the natural history of HIV along with reporting and treatment rates. Individual-level surveillance data for 1,077,295 cases (HIV/AIDS diagnoses, ART dispensations, CD4 counts and HIV/AIDS-related deaths) were used to calibrate the model using Bayesian inference.

The results showed a second wave of infections occurring after 2001 and 56,000 (95% Credible Interval 43,000–71,000) new infections in 2015, 37,000 (95% CrI 28,000–54,000) infections in men and 16,000 (95% CrI 10,000–23,000) in women. The estimated number of PLHIV by end-2015 was 838,000 (95% CrI 675,000–1,083,000), with 80% (95% CrI 62–98%) of those individuals reported to the Ministry of Health. Women were more likely to be diagnosed and reported than men; 86.8% of infected women had been reported compared with 75.7% of men. Likewise, ART initiation rates for women were higher than those for men.

The second wave contradicts previous estimates of HIV incidence trends in Brazil and there were persistent differences in the rates of accessing care between men and women. Nevertheless, the Brazilian HIV program has achieved high rates of detection and treatment, making considerable progress over the past ten years.

越来越多的证据表明，在巴西，特别是在男性中，艾滋病毒的发病率可能正在上升。在这里，我们使用巴西的综合卫生系统数据来开发数学模型，再现复杂的监视系统，并提供艾滋病毒发病率，艾滋病毒感染者人数（PLHIV），报告率和抗病毒治疗的起始率的估计值。

使用年龄结构确定性模型和弹性样条曲线来描述艾滋病毒的自然病史以及报告和治疗率。使用贝叶斯推断，对1,077,295例病例（HIV / AIDS诊断，ART分配，CD4计数和与HIV / AIDS相关的死亡）的个人水平监测数据进行了校准。

结果显示，2001年之后发生了第二波感染，2015年发生了56,000（95％可信区间43,000–71,000）新感染，男性感染了37,000（95％CrI 28,000–54,000）感染，16,000（95％CrI 10,000–23,000）感染。女人。到2015年底，估计的艾滋病毒感染者人数为838,000（955,000 CrI –1,083,000克里尔），其中80％（95％CrI 62-98％）向卫生部报告。女性比男性更有可能被诊断和报告。据报告，受感染的女性有86.8％，而男性为75.7％。同样，女性的抗逆转录病毒起始率高于男性。

第二波与先前对巴西艾滋病毒感染率趋势的估计相矛盾，男女之间获得护理的比率持续存在差异。尽管如此，巴西的艾滋病毒项目在过去的十年中取得了很高的发现和治疗率，并取得了长足的进步。