Predictors of advanced disease and late presentation in new HIV diagnoses reported to the surveillance system in Spain

Abstract

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.

Predictors of Delayed Diagnosis and Evolution in Sub-Saharan Immigrants with HIV Infection in a Hospital in Madrid (2004–2013)

“…The difference between the studies may be due to the different origins of the immigrants. In the majority of the studies in Spain and Europe, immigrants, especially Africans, are diagnosed later than the autochthonous population [4][5][6][7]14,21,22]. When we analyzed only the sub-Saharan subset, the delayed diagnosis results from Spain were similar to those of our study [3].…”

“…The high percentage of delayed diagnosis among patients in our cohort was higher than in most studies in Spain [3,6,7,[18][19][20]. In some cases, this difference can be explained by the definition of delayed diagnosis or differences in the study period.…”

“…Immigrants in the majority of studies (especially Africans) are diagnosed and begin treatment much later than the native populations [4][5][6][7][8]. This delayed diagnosis is also associated with the male sex, heterosexual transmission, intravenous drug use, and an older age at diagnosis [5][6][7][8][9].…”

“…This delayed diagnosis is also associated with the male sex, heterosexual transmission, intravenous drug use, and an older age at diagnosis [5][6][7][8][9]. Although the evolution of HIV infection does not seem to vary by origin, women and subSaharan Africans have been described as vulnerable populations [4,10].…”

HIV Testing Among Spanish Youth: Analysis of the Mediating Role of the Big Five Personality and Other Psychological Factors

“…According to the SINIVIH study in Spain, 48 % of new diagnoses were in fact a delayed diagnosis (less than 350 CD4) and 28 % advanced disease (less than 200 CD4). The profile of people who did not know their HIV status before diagnosis were patients younger than 25 years or those older than 44 years and who had heterosexual sex (7,8) . 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 Numerous studies developed in Spain have shown a high frequency of sexual risk behaviors among young heterosexuals and homosexuals (9)(10)(11)(12)(13)(14)(15), but few studies have examined the frequency of HIV antibody testing and determinants of delayed diagnosis (16).…”