Despite universal health care coverage in Spain, men, immigrants and people infected through drug use or heterosexual contact seem to be experiencing difficulties in gaining timely access to HIV care.

BackgroundIn Spain, the influenza vaccine effectiveness (VE) was estimated in the last three seasons using the observational study cycEVA conducted in the frame of the existing Spanish Influenza Sentinel Surveillance System. The objective of the study was to estimate influenza vaccine effectiveness (VE) against medically attended, laboratory-confirmed influenza-like illness (ILI) among the target groups for vaccination in Spain in the 2011–2012 season. We also studied influenza VE in the early (weeks 52/2011-7/2012) and late (weeks 8-14/2012) phases of the epidemic and according to time since vaccination.MethodsMedically attended patients with ILI were systematically swabbed to collect information on exposure, laboratory outcome and confounding factors. Patients belonging to target groups for vaccination and who were swabbed <8 days after symptom onset were included. Cases tested positive for influenza and controls tested negative for any influenza virus. To examine the effect of a late season, analyses were performed according to the phase of the season and according to the time between vaccination and symptoms onset.ResultsThe overall adjusted influenza VE against A(H3N2) was 45% (95% CI, 0–69). The estimated influenza VE was 52% (95% CI, -3 to 78), 40% (95% CI, -40 to 74) and 22% (95% CI, -135 to 74) at 3.5 months, 3.5-4 months, and >4 months, respectively, since vaccination. A decrease in VE with time since vaccination was only observed in individuals aged ≥ 65 years. Regarding the phase of the season, decreasing point estimates were only observed in the early phase, whereas very low or null estimates were obtained in the late phase for the shortest time interval.ConclusionsThe 2011–2012 influenza vaccine showed a low-to-moderate protective effect against medically attended, laboratory-confirmed influenza in the target groups for vaccination, in a late season and with a limited match between the vaccine and circulating strains. The suggested decrease in influenza VE with time since vaccination was mostly observed in the elderly population. The decreasing protective effect of the vaccine in the late part of the season could be related to waning vaccine protection because no viral changes were identified throughout the season.

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This paper analyses late presentation (LP) of HIV infection, and its determinants, among men who have sex with men (MSM) in Spain, newly diagnosed with HIV (2003-2011) in 15 sexually transmitted infection/HIV counselling and testing clinics. LP was defined as <350 CD4 cells/µL or AIDS. In total, 3,081 MSM were included (2,499 having CD4/AIDS); overall LP was 25.3%. LP was higher in men older than 34 years, those not previously HIV-tested (adjusted odds ratio (aOR):3.1; 95% confidence intervals (CI):2.3-4.2) , and those tested > 12 months before diagnosis (12-24 months (aOR:1.4; 95% CI:1.0-2.0); > 24 months (aOR:2.2; 95% CI:1.7-3.0)). LP was less likely in MSM reporting a known HIV-infected partner as infection source or symptoms compatible with acute retroviral syndrome. 'Region of birth' interacted with 'educational level' and 'steady partner as infection source': only African and Latin-American MSM with low educational level were more likely to present late; Latin-American men attributing their infection to steady partner, but no other MSM, had LP more frequently. In Spain, HIV testing among MSM should be promoted, especially those > 34 years old and migrants with low educational level. The current recommendation that MSM be tested at least once a year is appropriate.

Uno de los grandes problemas del sistema educativo español es el alto porcentaje de estudiantes que abandonan la educación superior. Conocer qué factores inciden en el abandono, así como el perfil de los estudiantes que abandonan, puede ser útil para reducir esta problemática. Este artículo tiene como objetivo determinar las variables de entrada a la universidad asociadas al abandono en la Universidad Complutense de Madrid. La población del estudio corresponde al alumnado que formalizó la matrícula en el primer año de grado del curso académico 2017/18, conformado por un total de 12035 estudiantes, cuyos datos han sido proporcionados por el Observatorio del Estudiante de dicha universidad. En el análisis se aplica la técnica de regresión logística multinivel y árboles de decisión. Las variables independientes son de diferente naturaleza (demográficas, socioeconómicas y académicas) y suman un total de 14. Dentro del conjunto de predictores significativos (un total de 10), la dedicación del estudiante es la variable que más impacto tiene en el abandono; los estudiante con dedicación a tiempo parcial abandonan en mayor medida que los de tiempo completo. Además, las variables que discriminan y diferencian entre los estudiantes que abandonan y permanecen en la universidad son: dedicación del estudiante, edad, nota de acceso a la Universidad y área de conocimiento. El perfil del estudiante que abandona es el de un estudiante a tiempo parcial, de edad avanzada, con baja nota de acceso a la universidad y de las siguientes áreas de conocimiento: Ciencias, Artes y Humanidades, Ingeniería y Arquitectura y Ciencias Sociales y Jurídicas.  La principal conclusión del estudio es la relevancia de las variables previas a la entrada de la universidad en el abandono universitario. Por ello, a la hora de reducir esta problemática es fundamental el desarrollo de un enfoque preventivo y diagnóstico.