HIV / AIDS in SPAIN Bibliography: - Área de Vigilancia de VIH y Comportamientos de Riesgo. Vigilancia Epidemiológica del VIH y sida en España 2017: Sistema de Información sobre Nuevos DiagnósHcos de VIH y Registro Nacional de Casos de Sida. Plan Nacional sobre el Sida - D.G. de Salud Pública, Calidad e Innovación / Centro Nacional de Epidemiología - ISCIII. Madrid; Nov 2018. - hSps://aidsinfo.unaids.org (consulted in July 2019) - GeSIDA AnHretroviral Therapy Guidelines, 2019. hSp://gesida-seimc.org/wp-content/uploads/2019/02/Guia_Tar_Gesida_Ene_2019.pdf - J. Alcamí et al. Situación de la invesHgación sobre el VIH en España. Enferm Infecc Microbiol Clin 2018;36(Supl 1):26-30. - Morán-Arribas et al. Magnitud de la infección por VIH, poblaciones vulnerables y barreras de acceso a la atención sanitaria. Enferm Infecc Microbiol Clin 2018;36(Supl 1):3-9. PEOPLE NEWLY DIAGNOSED WITH HIV (2017) 3,381 (rate 7.3/100,000 habitants) (data not corrected by notification delay) AIDS-RELATED DEATHS Alexy Inciarte 1 , Lourdes Domínguez 2 1 Hospital Universitario Clínic - Barcelona 2 Hospital Universitario 12 de Octubre - Barcelona CURRENT CHALLENGES 2019 Median age: 35 years old (IQR:28-44) 15-24 years old: 11.9% >50 years old: 14.8% Spain: 60.4% Latin America: 19.0% Sub-Saharan Africa: 7.2% Late diagnosis: 1,352 paHents - represents 47.8% out of 2,829 paHents with available CD4+ cell count data - >% in women (50.6%), people from Sub-Saharan Africa (55.2%) and LaHn America (51.8%), and people ≥50 years old (65.2%) MEN (n=2,861) WOMEN (n=520) MSM 64.2% Blood products 0.1% Heterosex 17.9% VerHcal 0.1% Unknown 14.4% Other 0.5% IDU 2.9% Heterosex 85.0% VerHcal 0.6% Unknown 9.2% Other 0.4% IDU 4.2% Blood products 0.6% 2009-2017 rate of new HIV diagnosis according to transmission mechanism and gender (data corrected by noZficaZon delay - do\ed lines represent data corrected by delayed noZficaZon) Rate for every 100,000 habitants Year of diagnosis Rate for every 100,000 habitants Year of diagnosis ___ Men ___ Women ___ Total ___ MSM ___ Heterosex ___ IDU HIV TREATMENT CASCADE (2018) 74% 81% 83% 84% 73% PLWH in Spain: 150,000 (130,000 – 170,000) Preferred regimens: TAF/FTC/BIC TAF/FTC+RAL TAF/FTC+DTG ABC/3TC/DTG Alternative regimens: TAF/FTC/EVG/Cobi 3TC+DTG TAF/FTC/DRV/Cobi TAF/FTC+DRV/r TAF/FTC+DOR TDF/3TC/DOR TAF/FTC/RPV PrEP EARLY DIAGNOSIS INVESTMENT IN RESEARCH Percentage variaHon in investment in I+D in the 2009-2016 period. Adapted from: J. Alcamí et al. Enferm Infecc Microbiol Clin 2018;36(Supl 1):26-30 -9.1 Spain 12.5 13.6 Italy France 27.4 EU-28 United Kingdom 39.7 37.9 Germany Barriers to access to care in Spain - derived from the Spanish Health System · lack of moHvaHon in Primary Care (scarcity of Hme…) · lack of specific formaHon on InfecHous Diseases · lack of language services · difficulHes when managing sexual topics in the clinic interview · lack of awareness with gender and intercultural equality · administraHve procedures for immigrants - derived from the paHents · sHgma · fear of lack of confidenHality · low risk percepHon · lack of knowledge of where to get tested Real Decreto 1083/2017 at last, non-prescribed HIV self-tesZng available in 2018!
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HIV / AIDS in SPAIN
Bibliography: - Área de Vigilancia de VIH y Comportamientos de Riesgo. Vigilancia Epidemiológica del VIH y sida en España 2017: Sistema de Información sobre Nuevos DiagnósHcos de VIH y Registro Nacional de Casos de Sida. Plan Nacional sobre el Sida - D.G. de Salud Pública, Calidad e
Innovación / Centro Nacional de Epidemiología - ISCIII. Madrid; Nov 2018. - hSps://aidsinfo.unaids.org (consulted in July 2019)- GeSIDA AnHretroviral Therapy Guidelines, 2019. hSp://gesida-seimc.org/wp-content/uploads/2019/02/Guia_Tar_Gesida_Ene_2019.pdf- J. Alcamí et al. Situación de la invesHgación sobre el VIH en España. Enferm Infecc Microbiol Clin 2018;36(Supl 1):26-30.- Morán-Arribas et al. Magnitud de la infección por VIH, poblaciones vulnerables y barreras de acceso a la atención sanitaria. Enferm Infecc Microbiol Clin 2018;36(Supl 1):3-9.
PEOPLE NEWLY DIAGNOSED WITH HIV (2017)3,381 (rate 7.3/100,000 habitants)
(data not corrected by notification delay)
AIDS-RELATED DEATHS
Alexy Inciarte1, Lourdes Domínguez2
1 Hospital Universitario Clínic - Barcelona2 Hospital Universitario 12 de Octubre - Barcelona
CURRENT CHALLENGES
2019
Median age: 35 years old (IQR:28-44)15-24 years old: 11.9%>50 years old: 14.8%
Spain: 60.4%Latin America: 19.0%Sub-Saharan Africa: 7.2%
Late diagnosis: 1,352 paHents- represents 47.8% out of 2,829 paHents with availableCD4+ cell count data- >% in women (50.6%), people from Sub-SaharanAfrica (55.2%) and LaHn America (51.8%), and people≥50 years old (65.2%)MEN (n=2,861) WOMEN (n=520)
MSM 64.2%
Blood products
0.1%
Heterosex17.9%
VerHcal 0.1% Unknown
14.4%
Other 0.5%
IDU 2.9%
Heterosex85.0%
VerHcal 0.6% Unknown
9.2%
Other 0.4%
IDU 4.2%
Blood products
0.6%
2009-2017 rate of new HIV diagnosis according to transmission mechanism and gender(data corrected by noZficaZon delay - do\ed lines represent data corrected by delayed noZficaZon)
Rate
fore
very
100,
000
habi
tant
s
Year of diagnosis
Rate
fore
very
100,
000
habi
tant
s
Year of diagnosis
___ Men___ Women___ Total
___ MSM___ Heterosex___ IDU
HIV TREATMENT CASCADE (2018)
74%81%
83%
84%
73%
PLWH in Spain: 150,000 (130,000 – 170,000)
Preferred regimens:TAF/FTC/BICTAF/FTC+RALTAF/FTC+DTGABC/3TC/DTG
Alternative regimens:TAF/FTC/EVG/Cobi3TC+DTGTAF/FTC/DRV/CobiTAF/FTC+DRV/rTAF/FTC+DORTDF/3TC/DORTAF/FTC/RPV
PrEP EARLY DIAGNOSIS INVESTMENT IN RESEARCH
Percentage variaHon in investment in I+D in the 2009-2016 period. Adapted from: J. Alcamí et al. Enferm Infecc Microbiol Clin 2018;36(Supl 1):26-30
-9.1 Spain
12.5
13.6
Italy
France
27.4EU-28
United Kingdom 39.7
37.9Germany
Barriers to access to care in Spain- derived from the Spanish Health System
· lack of moHvaHon in Primary Care (scarcity of Hme…)· lack of specific formaHon on InfecHous Diseases· lack of language services· difficulHes when managing sexual topics in the clinic interview· lack of awareness with gender and intercultural equality · administraHve procedures for immigrants
- derived from the paHents· sHgma· fear of lack of confidenHality· low risk percepHon· lack of knowledge of where to get tested
Real Decreto 1083/2017
at last, non-prescribed HIV self-tesZng
available in 2018!
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