Abstract：
OBJECTIVE:To present surveillance data on advanced disease (AD) and late presentation (LP) of HIV in Spain and their determinants. METHODS:We included all new HIV diagnoses notified by the autonomous regions that consistently reported such cases throughout the period 2007-2011. Coverage was 54% of the total Spanish population. Data sources consisted of clinicians, laboratories and medical records. AD was defined as the presence of a CD4 cell count <200cells/μL in the first test after HIV diagnosis, while LP was defined as the presence of a CD4 cell count <350cells/μL after HIV diagnosis. Odds ratios and their 95% confidence intervals (OR, 95% CI) were used as the measure of association. Logistic regressions were fit to identify predictors of AD and LP. RESULTS:A total of 13,021 new HIV diagnoses were included. Among these, data on the outcome variable were available in 87.7%. The median CD4 count at presentation was 363 (interquartile range, 161-565). Overall, 3356 (29.4%) patients met the definition of AD and 5494 (48.1%) were classified as LP. Both AD and LP increased with age and were associated with male sex and infection through drug use or heterosexual contact. All immigrants except western Europeans were more prone to AD and LP. Multivariate models disaggregated by sex showed that the effect of age and region of origin was weaker in women than in men. CONCLUSIONS: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.
journal_name
Gac Sanitjournal_title
Gaceta sanitariaauthors
Oliva J,Díez M,Galindo S,Cevallos C,Izquierdo A,Cereijo J,Arrillaga A,Nicolau A,Fernández A,Alvarez M,Castilla J,Martínez E,López I,Vivés Ndoi
10.1016/j.gaceta.2013.06.009subject
Has Abstractpub_date
2014-03-01 00:00:00pages
116-22issue
2eissn
0213-9111issn
1578-1283pii
S0213-9111(13)00137-4journal_volume
28pub_type
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