Estimating the HIV undiagnosed population in Catalonia, Spain : descriptive and comparative data analysis to identify differences in MSM stratified by migrant and Spanish-born population
Reyes-Urueña, Juliana (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i Medicina Preventiva i Salut Pública)
Campbell, Colin N. J. (Public Health England)
Vives, Núria (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i Medicina Preventiva i Salut Pública)
Esteve, Anna (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i Medicina Preventiva i Salut Pública)
Ambrosioni, Juan (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Tural, Cristina (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Ferrer, Elena (Hospital Universitari de Bellvitge)
Navarro Rubio, Gemma (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Force, Lluís (Hospital de Mataró. Consorci Sanitari del Maresme)
García, Isabel (Hospital General d'Hospitalet)
Masabeu, Àngels (Hospital Universitario de Palamós)
Vilaró, Josep M. (Consorci Hospitalari de Vic)
García de Olalla, Patricia (Agència de Salut Pública de Barcelona)
Caylà, Joan A. (Agència de Salut Pública de Barcelona)
Miró, Josep M. (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Casabona-Barbarà, Jordi (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i Medicina Preventiva i Salut Pública)

Date:	2018
Abstract:	Undiagnosed HIV continues to be a hindrance to efforts aimed at reducing incidence of HIV. The objective of this study was to provide an estimate of the HIV undiagnosed population in Catalonia and compare the HIV care cascade with this step included between high-risk populations. To estimate HIV incidence, time between infection and diagnosis and the undiagnosed population stratified by CD4 count, we used the ECDC HIV Modelling Tool V. 1. 2. 2. This model uses data on new HIV and AIDS diagnoses from the Catalan HIV/AIDS surveillance system from 2001 to 2013. Data used to estimate the proportion of people enrolled, on ART and virally suppressed in the HIV care cascade were derived from the PISCIS cohort. The total number of people living with HIV (PLHIV) in Catalonia in 2013 was 34 729 (32 740 to 36 827), with 12. 3% (11. 8 to 18. 1) of whom were undiagnosed. By 2013, there were 8458 (8101 to 9079) Spanish-born men who have sex with men (MSM) and 2538 (2334 to 2918) migrant MSM living with HIV in Catalonia. A greater proportion of migrant MSM than local MSM was undiagnosed (32% vs 22%). In the subsequent steps of the HIV care cascade, migrants MSM experience greater losses than the Spanish-born MSM: in retention in care (74% vs 55%), in the proportion on combination antiretroviral treatment (70% vs 50%) and virally suppressed (65% vs 46%). By the end of 2013, there were an estimated 34 729 PLHIV in Catalonia, of whom 4271 were still undiagnosed. This study shows that the Catalan epidemic of HIV has continued to expand with the key group sustaining HIV transmission being MSM living with undiagnosed HIV.
Grants:	Ministerio de Economía, Industria y Competitividad 15/00168
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	HIV surveillance ; HIV undiagnosed infection ; Continuum of care ; Migrant ; MSM ; Cascade
Published in:	BMJ open, Vol. 8 (february 2018) , ISSN 2044-6055

DOI: 10.1136/bmjopen-2017-018533
PMID: 29490955

9 p, 1.3 MB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Parc Taulí Research and Innovation Institute (I3PT
Articles > Research articles
Articles > Published articles