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Bruguera A, Egea-Cortés L, Mesías-Gazmuri J, Palacio-Vieira J, Forero CG, Miranda C, Saumoy M, Fernández E, Navarro G, Orti A, Miró JM, Casabona J, Reyes-Urueña J. Predictors of poor health-related quality of life among people living with HIV aged ≥60 years in the PISCIS cohort: Findings from the Vive+ project. HIV Med 2024; 25:424-439. [PMID: 38092529 DOI: 10.1111/hiv.13590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/11/2023] [Indexed: 04/05/2024]
Abstract
INTRODUCTION Advancements in and accessibility to effective antiretroviral therapy has improved the life expectancy of people living with HIV, increasing the proportion of people living with HIV reaching older age (≥60 years), making this population's health-related quality of life (HRQoL) more relevant. Our aim was to identify the determinants of poor HRQoL in people living with HIV aged ≥60 years and compare them with those of their younger counterparts. METHODS We used data from the 'Vive+' study, a cross-sectional survey conducted between October 2019 and March 2020, nested within the PISCIS cohort of people living with HIV in Catalonia and the Balearic Islands, Spain. We used the 12-item short-form survey (SF-12), divided into a physical component summary (PCS) and a mental component summary (MCS), to evaluate HRQoL. We used the least absolute shrinkage and selection operator for variable selection and used multivariable regression models to identify predictors. RESULTS Of the 1060 people living with HIV (78.6% males) who participated in the study, 209 (19.7%) were aged ≥60 years. When comparing older people living with HIV (≥60 years) and their younger counterparts, older people exhibited a worse PCS (median 51.3 [interquartile range {IQR} 46.0-58.1] vs. 46.43 [IQR 42.5-52.7], p < 0.001) but a similar MCS (median 56.0 [IQR 49.34-64.7] vs. 57.0 [IQR 48.9-66.3], p = 0.476). In the multivariable analysis, cognitive function correlated with a PCS (β correlation factor [β] -0.18, p = 0.014), and depressive symptoms and satisfaction with social role correlated with an MCS (β 0.61 and β -0.97, respectively, p < 0.001) in people living with HIV aged ≥60 years. CONCLUSION Depressive symptoms, poor cognitive function, and lower satisfaction with social roles predict poorer HRQoL in older people living with HIV. These factors need to be considered when designing targeted interventions.
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Affiliation(s)
- Andreu Bruguera
- Methodology of Biomedical Research and Public Health, Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine, and Public Health, Univ Autonoma de Barcelona, Badalona, Spain
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - L Egea-Cortés
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
| | - J Mesías-Gazmuri
- Methodology of Biomedical Research and Public Health, Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine, and Public Health, Univ Autonoma de Barcelona, Badalona, Spain
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
| | - J Palacio-Vieira
- Methodology of Biomedical Research and Public Health, Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine, and Public Health, Univ Autonoma de Barcelona, Badalona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - C G Forero
- Department of Medicine. School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat, Spain
| | - C Miranda
- Infectious Diseases, University Hospital Germans Trias i Pujol, Badalona, Spain
| | - M Saumoy
- HIV and STD Unit, Department of Infectious Diseases, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Spain
| | - E Fernández
- Infectious Diseases Service. Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - G Navarro
- HIV/AIDS Unit, Parc Taulí Hospital Universitario, Institut d'Ivestigació i Innovació Parc Tauli (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
| | - A Orti
- Verge de la Cinta Hospital, Tortosa, Spain
| | - J M Miró
- Infectious Diseases Service. Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - J Casabona
- Methodology of Biomedical Research and Public Health, Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine, and Public Health, Univ Autonoma de Barcelona, Badalona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine, Univ Autónoma de Barcelona, Badalona, Spain
| | - J Reyes-Urueña
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
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Ramírez-Olivencia G, Velasco Arribas M, Vera García MM, Casabona J, Martínez MJ, Membrillo De Novales FJ. Clinical and Epidemiological Characteristics of the 2022 Mpox Outbreak in Spain (CEME-22 Study). Open Forum Infect Dis 2024; 11:ofae105. [PMID: 38524223 PMCID: PMC10960598 DOI: 10.1093/ofid/ofae105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 02/22/2024] [Indexed: 03/26/2024] Open
Abstract
Background We conducted a multicentric national study (SEIMC-CEME-22), to describe the clinical and epidemiological profile of the mpox outbreak in Spain, including the management of the disease. Methods This was a retrospective national observational study conducted by Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC) and Foundation SEIMC-GESIDA. We included patients with a confirmed mpox diagnosis before 13 July 2022, and attended at the Spanish health network (the early phase of the outbreak). Epidemiological, clinical, and therapeutic data were collected. Results Of a total of 1472 patients from 52 centers included, 99% of them were cisgender men, mostly middle-aged, and 98.6% were residents in Spain. The main suspected route of transmission was sexual exposure, primarily among MSM. Occupational exposure was reported in 6 patients. Immunosuppression was present in 40% of patients, mainly due to human immunodeficiency virus (HIV). Only 6.5% of patients had been vaccinated against orthopoxvirus. Virus sequencing was performed in 147 patients (all B.1 lineage). Rash was the most frequent symptom (95.7%), followed by fever (48.2%), adenopathies (44.4%) myalgias (20.7%), proctitis (17%), and headache (14.7%). Simultaneously diagnosed sexually transmitted infections included syphilis (n = 129), gonococcal infection (n = 91), HIV (n = 67), chlamydia (n = 56), hepatitis B (n = 14), and hepatitis C (n = 11). No therapy was used in 479 patients (33%). Symptomatic therapies and antibiotics were used in 50% of cases. The most used therapy regimens were systemic corticoids (90 patients), tecovirimat (6 patients), and cidofovir (13 patients). Smallpox immunoglobulins were used in 1 patient. Fifty-eight patients were hospitalized, and 1 patient died. Conclusions Mpox outbreak in Spain affected primarily middle-aged men who were sexually active and showed a high rate of HIV infection. A range of heterogeneous therapeutics options was performed.
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Affiliation(s)
- G Ramírez-Olivencia
- Hospital Central de la Defensa "Gómez Ulla." Infectious Diseases Unit, Madrid, Spain
- Grupo de Estudio de Patología Importada, Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC), Madrid, Spain
| | - M Velasco Arribas
- Grupo de Estudio de Patología Importada, Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC), Madrid, Spain
- Hospital Fundación Alcorcón, Department of Internal Medicine-Infectious Department, Research Department, Alcorcón, Spain
| | - M M Vera García
- Centro Sanitario Sandoval, HIV/STI Unit, Madrid, Spain
- Grupo de Estudio de ITS, Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC), Madrid, Spain
| | - J Casabona
- Grupo de Estudio de ITS, Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC), Madrid, Spain
- Centre for Epidemiological Studies on HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
| | - M J Martínez
- Hospital Clinic, Microbiology Department, Barcelona, Spain
- Grupo de Estudio de Patología Importada, Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC), Madrid, Spain
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Vives N, Garcia de Olalla P, González V, Barrabeig I, Clotet L, Danés M, Borrell N, Casabona J. Recent trends in sexually transmitted infections among adolescents, Catalonia, Spain, 2012-2017. Int J STD AIDS 2020; 31:1047-1054. [PMID: 32753002 DOI: 10.1177/0956462420940911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Monitoring sexually transmitted infections (STIs) in adolescents is essential to inform STI prevention strategies at primary and secondary levels in this key population. We aim to describe recent trends in STIs among adolescents and to analyse their socio-demographic and behavioural characteristics in Catalonia, Spain between 2012 and 2017. Data on Chlamydia trachomatis (CT) infection, gonorrhoea and syphilis cases aged from 13 to 19 years reported to the Catalan Mandatory Notifiable System from 2012 to 2017 were analysed. Diagnosis rates were calculated and a descriptive analysis was performed. Between 2012 and 2017, CT infection, gonorrhoea and syphilis cases reported among adolescents aged 13-19 years accounted for more than one-eleventh of all reported cases in Catalonia. The rate of the three nationally-notifiable STIs increased dramatically among adolescents. CT infection rates rose from 13 to 144.1 per 100,000 adolescents between 2012 and 2017, an increase of 1007%; gonorrhoea cases increased by 246% (from 13.4 to 45.4/100,000) and syphilis cases increased by 247% (from 1.7 to 5.9/100,000). Gonorrhoea and syphilis cases affected mainly males while CT infection cases were mostly in females (84%). Adolescents are being increasingly affected by CT infection, gonorrhoea and syphilis. A broader array of intervention strategies aimed at adolescents should be reinforced through strong prevention campaigns, improved sexual health information, as well as encouragement of regular offers of STI screening by healthcare providers.
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Affiliation(s)
- N Vives
- Centre for Epidemiological Studies on STI/HIV/AIDS in Catalonia (CEEISCAT), Health Departament, Generalitat of Catalonia, Badalona, Spain.,Cancer Screening Unit, Catalan Institute of Oncology, Hospitalet de Llobregat, Spain.,CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - P Garcia de Olalla
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain.,Epidemiological Service of Public Health Agency of Barcelona, Barcelona, Spain
| | - V González
- Centre for Epidemiological Studies on STI/HIV/AIDS in Catalonia (CEEISCAT), Health Departament, Generalitat of Catalonia, Badalona, Spain.,CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain.,Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain.,Microbiology Service, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - I Barrabeig
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain.,Epidemiological Surveillance and Response to Public Health Emergencies Service in Barcelona South, Agency of Public Health of Catalonia, Generalitat of Catalonia, Hospitalet del Llobregat, Spain
| | - L Clotet
- Epidemiological Surveillance and Response to Public Health Emergencies Service in Vallès Occidental and Vallès Oriental, Agency of Public Health of Catalonia, Generalitat of Catalonia, Sant Cugat del Vallès, Spain
| | - M Danés
- Epidemiological Surveillance and Response to Public Health Emergencies Service in Girona, Agency of Public Health of Catalonia, Generalitat of Catalonia, Girona, Spain
| | - N Borrell
- Epidemiological Surveillance and Response to Public Health Emergencies Service in Tarragona Camp, Agency of Public Health of Catalonia, Generalitat of Catalonia, Tarragona, Spain
| | - J Casabona
- Centre for Epidemiological Studies on STI/HIV/AIDS in Catalonia (CEEISCAT), Health Departament, Generalitat of Catalonia, Badalona, Spain.,CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain.,Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain.,Department of Paediatrics, Obstetrics, Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
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Saludes V, Antuori A, Lazarus JV, Folch C, González-Gómez S, González N, Ibáñez N, Colom J, Matas L, Casabona J, Martró E. Evaluation of the Xpert HCV VL Fingerstick point-of-care assay and dried blood spot HCV-RNA testing as simplified diagnostic strategies among people who inject drugs in Catalonia, Spain. Int J Drug Policy 2020; 80:102734. [PMID: 32470849 DOI: 10.1016/j.drugpo.2020.102734] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/14/2020] [Accepted: 03/17/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Catalonia requires decentralized and simplified strategies for the diagnosis of viremic HCV infection among people who inject drugs (PWID). We aimed to perform a direct comparison of the diagnostic performance between two, single-step strategies for the screening and diagnosis of viremic HCV infection in PWID attending a drug consumption room (DCR) in Barcelona: i) on-site HCV-RNA testing using the point-of-care test (PoCT) Xpert HCV VL Fingerstick; and ii) on-site dried blood spots (DBS) collection for HCV-RNA testing at the laboratory (in-house assay). Additionally, we aimed to assess participants' preferences in receiving HCV-RNA testing results and feasibility of same-day delivery of PoCT results. METHODS The real-world, clinical performance of these two strategies was established in comparison with the reference method (HCV viral load testing with the Xpert HCV Viral Load assay at the laboratory from venous plasma collected at the DCR). HCV genotypes/subtypes and HIV status were also determined by sequencing and serology, respectively. A questionnaire including preferences regarding the delivery of test results was administered. RESULTS The prevalence of HCV-RNA was 63.0% (of which 25.8% were co-infected with HIV). The RNA-PoCT showed a sensitivity of 98.4% for detectable viral loads (>4 IU/mL) and of 100% for quantifiable viral loads (≥10, ≥1000 and ≥3000 IU/mL). For the DBS-based assay, a sensitivity of 93.7% was obtained for detectable viral loads, 96.7% for the quantifiable ≥10 IU/mL threshold, and 98.3% for both the quantifiable ≥1000 and ≥3000 IU/mL thresholds. No significant differences were detected between the sensitivity values of these two strategies, and the specificity was 100% in both cases. Half of the participants preferred to receive the HCV-RNA result on the same day, and 80% of participants received their RNA-PoCT results on the same day. CONCLUSIONS Both the HCV-RNA PoCT and the DBS-based assay are highly reliable tools for the simplified diagnosis of viremic HCV infection among current PWID. These strategies allow for on-site sample collection and delivery of test results, facilitating decentralized care in harm reduction services.
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Affiliation(s)
- V Saludes
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Genetics and Microbiology Department, Universitat Autònoma de Barcelona, Badalona, Spain; Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain; Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - A Antuori
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Genetics and Microbiology Department, Universitat Autònoma de Barcelona, Badalona, Spain; Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - J V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - C Folch
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Centre for Epidemiological Studies on Sexually Transmitted Infections and HIV/AIDS of Catalonia (CEEISCAT), Public Health Agency of Catalonia (ASPCAT), Badalona, Spain
| | - S González-Gómez
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Genetics and Microbiology Department, Universitat Autònoma de Barcelona, Badalona, Spain; Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - N González
- Drug consumption room "El Local", IPSS Foundation, Sant Adrià del Besòs, Barcelona, Spain
| | - N Ibáñez
- Program on Substance Abuse, ASPCAT, Barcelona, Spain
| | - J Colom
- Program for the Prevention, Control and Treatment of HIV, Sexually Transmitted Infections and Viral Hepatitis, ASPCAT, Barcelona, Spain
| | - L Matas
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Genetics and Microbiology Department, Universitat Autònoma de Barcelona, Badalona, Spain; Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain; Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - J Casabona
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Centre for Epidemiological Studies on Sexually Transmitted Infections and HIV/AIDS of Catalonia (CEEISCAT), Public Health Agency of Catalonia (ASPCAT), Badalona, Spain
| | - E Martró
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Genetics and Microbiology Department, Universitat Autònoma de Barcelona, Badalona, Spain; Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain; Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
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Reyes-Urueña J, Fernàndez-Lopez L, Montoliu A, Conway A, Tavoschi L, Klavs I, Cosmaro L, Eibl I, Dominković Z, Pichon F, Casabona J. Assessing the quality of routine HIV testing data in the community setting 'COBATEST Network'. Int J STD AIDS 2019; 30:999-1008. [PMID: 31335272 DOI: 10.1177/0956462419857572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The COBATEST Network of Community-Based Voluntary Counselling and STI/HIV Testing (CBVCT) services was created to standardise monitoring and evaluation of CBVCT services across Europe. This study aims to assess the quality of data collected in the network from 2015 to 2016. A survey was completed by 34 COBATEST Network members and an evaluation was performed of data quality based on three dimensions: transcription validity, completeness and consistency. The weakest area that we identified was data management processes. Only 8.8% of services had a written procedure to address data quality errors, 29.4% had procedures in place to resolve discrepancies and 35.3% performed quality control. We found that 41.2% of services utilised the COBATEST data, 11.8% made decisions based on the COBATEST data and 61.8% analysed their data in an independent manner for internal purposes. We conclude that while services have reliable data to support planning and management of services, improvements to quality procedures would ensure data are translated into evidence. This evidence would support further expansion of CBVCT services in the EU/EEA, including the integration of CBVCT-generated data into national surveillance systems.
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Affiliation(s)
- J Reyes-Urueña
- 1 Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Catalonia, Spain.,2 Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
| | - L Fernàndez-Lopez
- 1 Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Catalonia, Spain.,2 Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain.,3 CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - A Montoliu
- 1 Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Catalonia, Spain.,2 Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain.,3 CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - A Conway
- 1 Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Catalonia, Spain.,2 Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
| | - L Tavoschi
- 4 European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.,5 Department of Translational research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - I Klavs
- 6 National Institute of Public Health, Ljubljana, Slovenia
| | | | - I Eibl
- 8 Aids Hilfe Wien, Austria
| | - Z Dominković
- 9 Iskorak - Sexual and Gender minorities' Rights Centre, Croatia
| | - F Pichon
- 10 The Danish AIDS Foundation, Denmark
| | - J Casabona
- 1 Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Catalonia, Spain.,2 Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain.,3 CIBER Epidemiología y Salud Pública (CIBERESP), Spain
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6
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Fernàndez-López L, Reyes-Urueña J, Agustí C, Kustec T, Serdt M, Klavs I, Casabona J. The COBATEST network: monitoring and evaluation of HIV community-based practices in Europe, 2014-2016. HIV Med 2019; 19 Suppl 1:21-26. [PMID: 29488701 DOI: 10.1111/hiv.12592] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The objective of this paper is to describe the data collected by the CBVCT services from the Community-based testing (COBATEST) network, from 2014 to 2016, in order to provide an insight into community-based voluntary counselling and testing (CBVCT) services' testing activity in Europe. METHODS A descriptive analysis of HIV testing activity in CBVCT services that are using the COBATEST tools was performed for the period 2014-2016. RESULTS During the study period, a total of 30 329 HIV tests were performed on 27 934 individuals, of which 1.8% were reactive. Of these reactive tests, 75.8% had a confirmatory test, 92.2% of those were confirmed as positive, and 90.38% of the confirmed positives were linked to care. The total number of tests performed over the study period increased 19.31%. The proportion of confirmatory tests increased from 63.0% to 90.0% and proportion linked to care increased from 84.1% to 93.8%. Most of the tested individuals were men (70.6%), aged between 21 and 35 years (58.5%) and non-foreign born (68.1%). A high proportion of individuals tested were men who have sex with men (MSM; 42.2%). The percentage of reactive screening tests was particularly high among transgender people (8.37%) and among male sex workers (6.38%). Repeat testers had a higher percentage of reactive tests (2.02%) than those tested for first time (1.1%). CONCLUSIONS These results prove the feasibility of collecting standardized data from CBVCT services in different countries across Europe and demonstrate the usefulness of such data.
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Affiliation(s)
- L Fernàndez-López
- Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Agència de Salut Pública de Catalunya (ASPC), Badalona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - J Reyes-Urueña
- Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Agència de Salut Pública de Catalunya (ASPC), Badalona, Spain
| | - C Agustí
- Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Agència de Salut Pública de Catalunya (ASPC), Badalona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - T Kustec
- National Institute of Public Health, Ljubljana, Slovenia
| | - M Serdt
- National Institute of Public Health, Ljubljana, Slovenia
| | - I Klavs
- National Institute of Public Health, Ljubljana, Slovenia
| | - J Casabona
- Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Agència de Salut Pública de Catalunya (ASPC), Badalona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Llibre JM, Montoliu A, Miró JM, Domingo P, Riera M, Tiraboschi J, Curran A, Homar F, Ambrosioni J, Abdulghani N, Force L, Peraire J, Casabona J. Discontinuation of dolutegravir, elvitegravir/cobicistat and raltegravir because of toxicity in a prospective cohort. HIV Med 2019; 20:237-247. [PMID: 30688007 DOI: 10.1111/hiv.12710] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of the study was to assess the rates of discontinuation of integrase inhibitor regimens because of any neuropsychiatric adverse event (NPAE) and the factors associated with discontinuation. METHODS A population-based, prospective, multicentre cohort study was carried out. Treatment-naïve subjects starting therapy with a regimen containing integrase inhibitors, or those switching to such a regimen, with plasma HIV-1 RNA < 50 HIV-1 RNA copies/mL in 14 hospitals in Catalonia or the Balearic Islands (Spain) were included in the study. Every discontinuation because of adverse events (AEs) was double-checked directly with treating physicians. Multivariable Cox models identified factors correlated with discontinuation. RESULTS A total of 4165 subjects (37% treatment-naïve) started regimens containing dolutegravir (n = 1650; 91% with abacavir), raltegravir (n = 930) or elvitegravir/cobicistat (n = 1585). There were no significant differences among regimens in the rate of discontinuation because of any AE. Rates of discontinuation because of NPAEs were low but higher for dolutegravir/abacavir/lamivudine [2.1%; 2.9 (95% confidence interval (CI) 2.0, 4.2) discontinuations/100 patients/year] versus elvitegravir/cobicistat (0.5%; 0.8 (95% CI 0.3, 1.5) discontinuations/100 patients/year], with significant differences among centres for dolutegravir/abacavir/lamivudine and NPAEs (P = 0.003). We identified an association of female gender and lower CD4 count with increased risk of discontinuation because of any AE [Incidence ratio (IR) 2.3 (95% CI 1.4, 4.0) and 1.8 (95% CI 1.1, 2.8), respectively]. Female gender, age > 60 years and abacavir use were not associated with NPAE discontinuations. NPAEs were commonly grade 1-2, and had been present before and improved after drug withdrawal. CONCLUSIONS In this large prospective cohort study, patients receiving dolutegravir, raltegravir or elvitegravir/cobicistat did not show significant differences in the rate of discontinuation because of any toxicity. The rate of discontinuations because of NPAEs was low, but was significantly higher for dolutegravir than for elvitegravir/cobicistat, with significant differences among centres, suggesting that greater predisposition to believe that a given adverse event is caused by a given drug of some treating physicians might play a role in the discordance seen between cohorts.
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Affiliation(s)
- J M Llibre
- Infectious Diseases and "Fight AIDS" Foundation, University Hospital Germans Trias i Pujol, Badalona, Spain
| | - A Montoliu
- Statistics and Epidemiology, Centre d'Estudis Epidemiològics sobre les ITS i la Sida de Catalunya (CEEISCAT, CIBERESP), Badalona, Spain
| | - J M Miró
- Hospital Clínic- IDIBAPS, University of Barcelona, Barcelona, Spain
| | - P Domingo
- Infectious Diseases, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - M Riera
- Hospital Son Espases, Palma de Mallorca, Spain
| | - J Tiraboschi
- Infectious Diseases, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - A Curran
- Infectious Diseases, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - F Homar
- Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - J Ambrosioni
- Hospital Clínic- IDIBAPS, University of Barcelona, Barcelona, Spain
| | | | - L Force
- Internal Medicine, Hospital de Mataró-Consorci Sanitari del Maresme, Mataró, Spain
| | - J Peraire
- Internal Medicine, Hospital Joan XXIII, Tarragona, Spain
| | - J Casabona
- Statistics and Epidemiology, Centre d'Estudis Epidemiològics sobre les ITS i la Sida de Catalunya (CEEISCAT, CIBERESP), Badalona, Spain
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8
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Jakobsen SF, Raben D, Sperle I, Lazarus JV, James C, Mendão L, de Wit J, Platteau T, von Lingen AI, Corbelli GM, Antoniadi C, Casabona J, West B, Rockstroh J, Delpech V. Scale-up of HIV self-testing. HIV Med 2018; 19. [PMID: 29737617 DOI: 10.1111/hiv.12618] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Affiliation(s)
| | - D Raben
- CHIP, Rigshospitalet, Copenhagen, Denmark
| | - I Sperle
- CHIP, Rigshospitalet, Copenhagen, Denmark
| | | | - C James
- European HIV-Hepatitis Testing Week, London, UK
| | - L Mendão
- GAT - Portuguese Activist Group for HIV/AIDS Treatment, Lisbon, Portugal
| | - J de Wit
- Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, the Netherlands
| | - T Platteau
- Institute of Tropical Medicine, Antwerp, Belgium
| | | | - G M Corbelli
- European AIDS Treatment Group, Brussels, Belgium
| | - C Antoniadi
- European AIDS Treatment Group, Brussels, Belgium
| | - J Casabona
- Centre for Epidemiological Studies of Sexually Transmitted Disease and AIDS in Catalonia (CEEISCAT), Badalona, Spain
| | - B West
- AIDS Action Europe, Berlin, Germany
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9
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Ferrer L, Gaillardin F, Cayuela A, Collazos F, Casabona J. 4.2-O5Self-reported health status among migrant men and women in Spain. PELFI Study. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky047.129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- L Ferrer
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Agència de Salut Publica de Catalunya (ASPC), Barcelona, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - F Gaillardin
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Agència de Salut Publica de Catalunya (ASPC), Barcelona, Spain
| | - A Cayuela
- Grupo de Investigación en Salud Pública. Universidad de Alicante, Spain
| | - F Collazos
- Instituto de Investigación Vall d’Hebrón, Hospital Vall d’Hebrón, Spain
| | - J Casabona
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Agència de Salut Publica de Catalunya (ASPC), Barcelona, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
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10
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Saludes V, Folch C, Morales-Carmona A, Ferrer L, Fernàndez-López L, Muñoz R, Jiménez M, Loureiro E, Fernández-Dávila P, Bascuñana E, Casabona J, Martró E. Community-based screening of hepatitis C with a one-step RNA detection algorithm from dried-blood spots: Analysis of key populations in Barcelona, Spain. J Viral Hepat 2018; 25:236-244. [PMID: 29053912 DOI: 10.1111/jvh.12809] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 08/15/2017] [Indexed: 12/30/2022]
Abstract
Alternative strategies are required to enhance the diagnosis of silent hepatitis C virus (HCV) infections in key populations at risk. Among them, HCV prevalence and bio-behavioural data are scarce for HIV-negative men who have sex with men (MSM) and men and trans-women sex workers. We sought to describe and assess the potential benefits of a community-based one-step HCV screening and confirmatory strategy for these populations in Barcelona. The screening strategy based on a real-time RT-PCR assay for HCV-RNA detection in dried-blood spots (DBS) was validated and implemented in addition to an antibody point-of-care test in a community centre. HCV prevalence was assessed, and bio-behavioural data were collected. The molecular assay was precise, reproducible, sensitive and specific. Four HIV-negative MSM reported being currently infected (0.75% HCV self-reported prevalence). Implementation of DBS testing was easy, and acceptability was >95%, but no silent HCV case was diagnosed (N = 580). High-risk sexual practices and drug use for sex were reported frequently. HIV prevalence was 4.7% in MSM and 10% in sex workers. Self-reported prevalence of other STIs ranged from 11.3% to 36.2%. In conclusion, HCV-RNA testing in DBS showed a good performance, but the assessed one-step strategy does not seem beneficial in this setting. Although no silent HCV infections were detected, the observed high-risk behaviours and prevalence of other STIs suggest that HCV spread should be periodically monitored among these populations in Barcelona by means of behavioural surveillance, rapid antibody testing and molecular confirmation in DBS.
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Affiliation(s)
- V Saludes
- Microbiology Service, Germans Trias i Pujol University Hospital, Germans Trias i Pujol Health Sciences Research Institute (IGTP), Badalona, Spain.,Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - C Folch
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Spain
| | | | - L Ferrer
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Spain
| | - L Fernàndez-López
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Spain
| | - R Muñoz
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Spain
| | - M Jiménez
- Microbiology Service, Germans Trias i Pujol University Hospital, Germans Trias i Pujol Health Sciences Research Institute (IGTP), Badalona, Spain
| | - E Loureiro
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Spain
| | - P Fernández-Dávila
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Spain.,Research Department, Stop Sida, Barcelona, Spain
| | - E Bascuñana
- Microbiology Service, Germans Trias i Pujol University Hospital, Germans Trias i Pujol Health Sciences Research Institute (IGTP), Badalona, Spain
| | - J Casabona
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Spain
| | - E Martró
- Microbiology Service, Germans Trias i Pujol University Hospital, Germans Trias i Pujol Health Sciences Research Institute (IGTP), Badalona, Spain.,Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
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11
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Reyes-Urueña J, Campbell C, Diez E, Ortún V, Casabona J. Can we afford to offer pre-exposure prophylaxis to MSM in Catalonia? Cost-effectiveness analysis and budget impact assessment. AIDS Care 2017; 30:784-792. [PMID: 29262694 DOI: 10.1080/09540121.2017.1417528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Pre-exposure prophylaxis (PrEP) effectiveness has been well established. This study aims to assess the cost-effectiveness of providing PrEP, estimate the number of eligible MSM, and its budget impact in Catalonia. Cost-effectiveness analysis compared costs of on daily basis and "on demand" PrEP to prevent one infection with lifetime costs of one HIV infection. We estimated the total cost of providing PrEP by estimating number of eligible MSM, and included in the budget impact assessment antiretroviral and laboratory costs. Costs were lower for the on-demand PrEP group by €64015.1 and the incremental benefit was nearly 15 life-years and 17 quality-adjusted life-years gained. The incremental cost-effectiveness ratio (ICER) was cost-effective at €6281.62 when undiscounted PrEP was given daily. On-demand PrEP can be considered cost-saving in 20 years if the price is reduced by 90%. The number of eligible MSM in Catalonia ranges from 5,989 to 10,972. At current antiretroviral costs, the annual cost would range between €25.3-46.7 million/year (on demand PrEP), and €42.9-78.7 million/year (daily basis PrEP). PrEP is most cost-effective if targeted towards groups with high incidence rates of over 3%/year. Beneficial ICER depends on reducing the current price of Truvada® and ensuring that effectiveness is maintained at high levels.
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Affiliation(s)
- J Reyes-Urueña
- a Centre for Epidemiological Studies on HIV/STI of Catalonia (CEEISCAT) , Agencia de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya , Badalona , Spain.,b The Institute for Health Science Research Germans Trias i Pujol (IGTP) , Badalona , Spain.,c Department of Paediatrics, Obstetrics and Gynaecology, and Preventive Medicine , Univ Autonoma Barcelona , Bellaterra , Spain.,d CIBER Epidemiologia y Salud Pública (CIBERESP) , Spain
| | - C Campbell
- e Tuberculosis Section, Centre for Infectious Disease Surveillance and Control, National Infection Service , Public Health England , London , England
| | - E Diez
- f Agència de Salut Pública de Barcelona (ASPB) , Barcelona , Spain
| | - V Ortún
- g Faculty of Economic and Business Sciences , Universitat Pompeu Fabra , Barcelona , Spain
| | - J Casabona
- a Centre for Epidemiological Studies on HIV/STI of Catalonia (CEEISCAT) , Agencia de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya , Badalona , Spain.,b The Institute for Health Science Research Germans Trias i Pujol (IGTP) , Badalona , Spain.,c Department of Paediatrics, Obstetrics and Gynaecology, and Preventive Medicine , Univ Autonoma Barcelona , Bellaterra , Spain.,d CIBER Epidemiologia y Salud Pública (CIBERESP) , Spain
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12
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Ferrer L, Gaillardin F, Cayuela A, Felt E, Hernando C, Collazos F, Ronda E, Casabona J. Children health determinants in a multi-site cohort of immigrant families in Spain (PELFI Study). Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw175.114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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13
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Ferrer L, Folch C, Fernandez-Davila P, Garcia A, Morales A, Belda J, Susperregui AR, Casabona J. Erratum to: Awareness of Pre-exposure Prophylaxis for HIV, Willingness to Use It and Potential Barriers or Facilitators to Uptake Among Men Who Have Sex with Men in Spain. AIDS Behav 2016; 20:1434. [PMID: 27262874 DOI: 10.1007/s10461-016-1395-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- L Ferrer
- Centre for Epidemiological Studies on STI and AIDS of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain. .,Institut d'Investigacio Germans Trias i Pujol (IGTP), Badalona, Spain. .,CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.
| | - C Folch
- Centre for Epidemiological Studies on STI and AIDS of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain.,Institut d'Investigacio Germans Trias i Pujol (IGTP), Badalona, Spain.,CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.,Department of Pediatrics, Obstetrics and Gynecology, and Preventive Medicine, Universitat Autonoma de Barcelona (UAB), Bellaterra (Cerdanyola), Spain
| | - P Fernandez-Davila
- Centre for Epidemiological Studies on STI and AIDS of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain.,Institut d'Investigacio Germans Trias i Pujol (IGTP), Badalona, Spain.,CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.,Stop Sida, Barcelona, Spain
| | - A Garcia
- Centre for Epidemiological Studies on STI and AIDS of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain
| | | | - J Belda
- Centro Información y Prevención del VIH/ITS (CIPS), Alicante, Barcelona, Spain
| | | | - J Casabona
- Centre for Epidemiological Studies on STI and AIDS of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain.,Institut d'Investigacio Germans Trias i Pujol (IGTP), Badalona, Spain.,CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.,Department of Pediatrics, Obstetrics and Gynecology, and Preventive Medicine, Universitat Autonoma de Barcelona (UAB), Bellaterra (Cerdanyola), Spain
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14
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Bell SA, Delpech V, Casabona J, Tsereteli N, de Wit J. Delivery of HIV test results, post-test discussion and referral in health care settings: a review of guidance for European countries. HIV Med 2015; 16:620-7. [DOI: 10.1111/hiv.12278] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2015] [Indexed: 10/23/2022]
Affiliation(s)
- SA Bell
- Centre for Social Research in Health; UNSW Australia; Sydney NSW Australia
| | | | - J Casabona
- Center for STI/HIV Epidemiological Studies of Catalonia (CEEISCAT/ASPCAT) and CIBERESP; Badalona Catalonia Spain
| | - N Tsereteli
- Centre for Information and Counseling on Reproductive Health - Tanadgoma; Tbilisi Georgia
| | - J de Wit
- Centre for Social Research in Health; UNSW Australia; Sydney NSW Australia
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15
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Fernández-Dávila P, Folch C, Ferrer L, Soriano R, Diez M, Casabona J. Who are the men who have sex with men in Spain that have never been tested for HIV? HIV Med 2014; 14 Suppl 3:44-8. [PMID: 24033904 DOI: 10.1111/hiv.12060] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The aims of the study were to describe the sociodemographic profile of men who have sex with men (MSM) who have never been tested for HIV and to analyse factors associated with never having been tested. METHODS The European MSM Internet Survey (EMIS) was implemented in 2010 in 38 European countries on websites for MSM and collected data on sociodemographics, sexual behaviour, and other sexual health variables. A logistic regression analysis was conducted to assess variables associated with never having been tested for HIV. RESULTS Of the 13,111 respondents living in Spain, 26% had never been tested for HIV. Those who had never been tested were significantly more likely to live in a settlement with fewer than 100,000 inhabitants, be younger than 25 years old, have a lower education level, be a student, and identify themselves as bisexual. In the multivariate analysis, to have never been tested for HIV was associated with being born in Spain [odds ratio (OR) 1.35; 95% confidence interval (CI) 1.192-1.539], living outside large settlements (OR 1.37; 95% CI 1.216-1.534), being younger than 25 years old (OR 2.94; 95% CI 2.510-3.441), being out to no one or only a few people (OR 2.16; 95% CI 1.938-2.399), having had no nonsteady partners in the last 12 months (OR 1.26; 95% CI 1.109-1.422), and being not at all confident to access HIV testing (OR 3.66; 95% CI 2.676-5.003), among others factors. CONCLUSIONS The profile of the MSM who had never been tested for HIV indicates that most of them were men who were hard to reach (young, bisexual men, in the closet). Interventions should aim to improve access to and the convenience of testing.
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Affiliation(s)
- P Fernández-Dávila
- Research Department, Stop Sida, Barcelona; Faculty of Psychology, Physical and Educational Sciences, Ramon Llull University, Barcelona
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16
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Agustí C, Fernàndez-López L, Mascort J, Carrillo R, Aguado C, Montoliu A, Puigdangolas X, De la Poza M, Rifà B, Casabona J. Attitudes to rapid HIV testing among Spanish General Practitioners. HIV Med 2014; 14 Suppl 3:53-6. [PMID: 24033906 DOI: 10.1111/hiv.12055] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The objectives of this study were to investigate the acceptability of rapid HIV testing among general practitioners in Spain and to identify perceived barriers and needs in order to implement rapid testing in primary care settings. METHODS An anonymous questionnaire was distributed online to all members of the two largest Spanish scientific medical societies for family and community medicine. The study took place between 15th June and 31st October 2010. RESULTS Completed questionnaires were returned by 1308 participants. The majority (90.8%) of respondents were General Practitioners (GP). Among all respondents, 70.4% were aware of the existence of rapid tests for the diagnosis of HIV but they did not know how to use them. Nearly 80% of participants would be willing to offer rapid HIV testing in their practices and 74.7% would be confident of the results obtained by these tests. The barriers most commonly identified by respondents were a lack of time and a need for training, both in the use of rapid tests (44.3% and 56.4%, respectively) and required pre- and post-test counselling (59.2% and 34.5%, respectively). CONCLUSIONS This study reveals a high level of acceptance and willingness on the part of GPs to offer rapid HIV testing in their practices. Nevertheless, the implementation of rapid HIV testing in primary care will not be possible without moving from comprehensive pre-test counselling towards brief pre-test information and improving training in the use of rapid tests.
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Affiliation(s)
- C Agustí
- Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT-ICO), Badalona; CIBER Epidemiología y Salud Pública, Barcelona
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17
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Vives N, Lugo R, López E, Garcia de Olalla P, Minguell S, Barrabeig I, Pons P, Lopez-Grado E, Ferré I, Escriche R, Armengol P, Vall M, Soler-Palacin P, Leon I, Gascon I, Vicente AM, Falguera G, Avecilla-Palau A, Martinez C, Barberá MJ, González V, Caylà J, Casabona J. Increase in gonorrhoea among very young adolescents, Catalonia, Spain, January 2012 to June 2013. Euro Surveill 2013; 18:20560. [DOI: 10.2807/1560-7917.es2013.18.33.20560] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- N Vives
- Department of Paediatrics, Obstetrics, Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Institut d'Investigació Germans Trias i Pujol (IGTP), Badalona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Centre for Epidemiological Studies on STI/HIV/AIDS in Catalonia (CEEISCAT)-ICO-Agència de Salut Pública de Catalunya, Barcelona, Spain
| | - R Lugo
- Institut d'Investigació Germans Trias i Pujol (IGTP), Badalona, Spain
- Centre for Epidemiological Studies on STI/HIV/AIDS in Catalonia (CEEISCAT)-ICO-Agència de Salut Pública de Catalunya, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - E López
- Department of Paediatrics, Obstetrics, Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Centre for Epidemiological Studies on STI/HIV/AIDS in Catalonia (CEEISCAT)-ICO-Agència de Salut Pública de Catalunya, Barcelona, Spain
- Institut d'Investigació Germans Trias i Pujol (IGTP), Badalona, Spain
| | - P Garcia de Olalla
- Epidemiological service of Public Health Agency of Barcelona, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - S Minguell
- Epidemiological Surveillance Unit of Tarragona, Tarragona, Spain
| | - I Barrabeig
- Epidemiological Surveillance Unit of Costa de Ponent, Hospitalet del Llobregat, Spain
| | - P Pons
- Epidemiological Surveillance Unit of Tarragona, Tarragona, Spain
| | - E Lopez-Grado
- Reproductive and Sexual Health Care Programme, Centre d'Atenció Primària (CAP) Sant Fèlix, Institut Català de la Salut (ICS) , Sabadell, Spain
| | - I Ferré
- Reproductive and Sexual Health Care Centre, Badalona Serveis Assistencials (BSA) , Badalona, Spain
| | - R Escriche
- Reproductive and Sexual Health Care Programme, CAP Manso, ICS, Barcelona, Spain
| | - P Armengol
- Sexually Transmitted Infections Unit, Hospital Universitari Vall d’Hebrón, ICS, Barcelona, Spain
| | - M Vall
- Sexually Transmitted Infections Unit, Hospital Universitari Vall d’Hebrón, ICS, Barcelona, Spain
| | - P Soler-Palacin
- Unitat de Patologia Infecciosa i Immunodeficiències de Pediatria. Hospital Universitari Vall d'Hebron, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - I Leon
- CAP La Marina, ICS, Barcelona, Spain
| | - I Gascon
- CAP La Marina, ICS, Barcelona, Spain
| | - A M Vicente
- CAP Roquetes-Canteres, ICS, Barcelona, Spain
| | - G Falguera
- Reproductive and Sexual Health Care Programme, Centre d'Atenció Primària (CAP) Sant Fèlix, Institut Català de la Salut (ICS) , Sabadell, Spain
| | - A Avecilla-Palau
- Reproductive and Sexual Health Care Centre, Badalona Serveis Assistencials (BSA) , Badalona, Spain
| | - C Martinez
- Reproductive and Sexual Health Care Programme, CAP Manso, ICS, Barcelona, Spain
| | - M J Barberá
- Sexually Transmitted Infections Unit, Hospital Universitari Vall d’Hebrón, ICS, Barcelona, Spain
| | - V González
- Microbiology Service, Hospital Universitari Germans Trias i Pujol, ICS, Badalona, Spain
- Institut d'Investigació Germans Trias i Pujol (IGTP), Badalona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Centre for Epidemiological Studies on STI/HIV/AIDS in Catalonia (CEEISCAT)-ICO-Agència de Salut Pública de Catalunya, Barcelona, Spain
| | - J Caylà
- Epidemiological service of Public Health Agency of Barcelona, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - J Casabona
- Department of Paediatrics, Obstetrics, Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Institut d'Investigació Germans Trias i Pujol (IGTP), Badalona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Centre for Epidemiological Studies on STI/HIV/AIDS in Catalonia (CEEISCAT)-ICO-Agència de Salut Pública de Catalunya, Barcelona, Spain
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18
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Tuneu MJ, Vallès X, Carnicer-Pont D, Barberá MJ, Godoy P, Avecilla-Palau A, Jordà B, Lopez-Grado E, Rivero D, Vives A, Acera A, Almirall R, Crespo N, Casabona J, the Partner Notification Study Group C. Pilot study to introduce a notification card for partner notification of sexually transmitted infections in Catalonia, Spain, June 2010 to June 2011. Euro Surveill 2013; 18. [DOI: 10.2807/1560-7917.es2013.18.27.20516] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We conducted a cross-sectional study in 10 primary care centres in Catalonia, to determine applicability, acceptability and effectiveness of partner notification cards used by patients diagnosed of a sexually transmitted infection (STI) and to characterise these and their sexual partners. Statutorily notifiable STIs included Chlamydia infection, gonorrhoea, syphilis, human immunodeficiency virus (HIV) infection or other STIs as deemed necessary by the treating physician. Between June 2010 and June 2011, 219 index cases were enrolled, of whom 130 were men (59.4%), 71 of them men who have sex with men (54.6%). Chlamydia infection (41.1%), gonorrhoea (17.8%) and syphilis (16.0%) were the STIs most frequently diagnosed. HIV infection accounted for 4% of cases. A total of 687 sexual partners were reported, and 300 of these were traceable through the notification card (45.7%). Those who did not report traceable contacts were older (mean age: 34 years versus 31 years, p=0.03). The main reason for not distributing the card was anonymous sexual intercourse (38%). Patient referral notification cards can reach a high percentage of sexual partners at risk. However, only few notified sexual partners attended participating health centres. Internet-based partner notification may be considered in order to reach those partners not otherwise traceable.
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Affiliation(s)
- M J Tuneu
- Pompeu Fabra University, Barcelona, Spain
- Centre for Epidemiological Studies on Sexually Transmitted Infections and HIV/AIDS of Catalonia (CEEISCAT), Catalan Institute of Oncology (ICO), Public Health Agency of Catalonia (ASPCAT), Barcelona, Spain
| | - X Vallès
- Centre for Epidemiological Studies on Sexually Transmitted Infections and HIV/AIDS of Catalonia (CEEISCAT), Catalan Institute of Oncology (ICO), Public Health Agency of Catalonia (ASPCAT), Barcelona, Spain
| | - D Carnicer-Pont
- Centros de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Spain
- Department of Paediatrics, Obstetrics, Gynaecology and Public Health of the Autonomous University of Barcelona, Bellaterra, Barcelona, Spain
- Centre for Epidemiological Studies on Sexually Transmitted Infections and HIV/AIDS of Catalonia (CEEISCAT), Catalan Institute of Oncology (ICO), Public Health Agency of Catalonia (ASPCAT), Barcelona, Spain
| | - M J Barberá
- Sexually Transmitted Infections Unit, Drassanes Primary Health Centre, Catalan Institute of Health, Barcelona, Spain
| | - P Godoy
- Epidemiological Surveillance Unit, Lleida, Spain
- Centros de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Spain
| | - A Avecilla-Palau
- Care Programme for sexual and reproductive health, Badalona Care Services, Barcelona, Spain
| | - B Jordà
- Care programme for sexual and reproductive health, Catalan Institute of Health, Barcelona, Spain
| | - E Lopez-Grado
- Care programme for sexual and reproductive health, Catalan Institute of Health, Sabadell, Spain
| | - D Rivero
- Salt Primary Health Centre, Catalan Institute of Health, Girona, Spain
| | - A Vives
- Department of Andrology, Puigvert Foundation, Barcelona, Spain
| | - A Acera
- Sexually Transmitted Infections Unit, Cerdanyola Primary Health Centre, Catalan Institute of Health, Barcelona, Spain
| | - R Almirall
- Care programme for sexual and reproductive health, Catalan Institute of Health, Esquerra de l’Eixample, Barcelona, Spain
| | - N Crespo
- Care programme for sexual and reproductive health, Catalan Institute of Health, Manresa, Barcelona, Spain
| | - J Casabona
- Centros de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Spain
- Department of Paediatrics, Obstetrics, Gynaecology and Public Health of the Autonomous University of Barcelona, Bellaterra, Barcelona, Spain
- Centre for Epidemiological Studies on Sexually Transmitted Infections and HIV/AIDS of Catalonia (CEEISCAT), Catalan Institute of Oncology (ICO), Public Health Agency of Catalonia (ASPCAT), Barcelona, Spain
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19
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Smith A, Sabidó M, Camey E, Batres A, Casabona J. P6.064 Integrating Simultaneous Triple Point-Of-Care Screening for Syphilis, Hepatitis B and HIV in Antenatal Services Through Rural Outreach Teams in Guatemala. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.1217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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20
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Vives N, Carnicer-Pont D, García de Olalla P, Camps N, Esteve A, Casabona J. Factors associated with late presentation of HIV infection in Catalonia, Spain. Int J STD AIDS 2013; 23:475-80. [PMID: 22844000 DOI: 10.1258/ijsa.2011.011280] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We sought to describe the prevalence, trends and factors associated with late diagnosis of HIV infection between 2001 and 2008 in Catalonia, Spain. Adults over 13 years of age with available CD4 cell counts, who were notified to the Catalonia Voluntary HIV Surveillance System between January 2001 and December 2008, were included in the study. Late presentation for HIV infection was defined as a CD4 cell count <350 cells/μL or with an AIDS-defining condition at presentation. Multivariable logistic regression was used to identify factors independently associated with late diagnosis of HIV. Of the 4651 newly diagnosed HIV-infected individuals with available CD4 counts, 2598 (55.9%) were diagnosed late. The proportion of people with a late diagnosis decreased from 60.4% in 2001 to 50% in 2008, a significant trend (P < 0.001). Older age, male gender, foreign birth, heterosexuality and injecting drug use were independent risk factors for late diagnosis. Strategies to actively promote HIV testing to populations at risk of late diagnosis of HIV or those never attending health systems should be implemented.
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Affiliation(s)
- N Vives
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Institut català d'Oncologia (ICO), DGSP, Generalitat de Catalunya, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, 08916 Badalona, Spain.
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21
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Folch C, Lazar C, Ferrer L, Sanclemente C, Casabona J. Female sex workers and access to social and health services in Catalonia: Influence of region of origin and place of work. AIDS Care 2012; 25:1033-8. [DOI: 10.1080/09540121.2012.748872] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- C. Folch
- Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT) – ICO - Agència de Salut Pública de Catalunya, Badalona, Spain
- Ciber de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Department of Paediatrics, Obstetrics and Gynaecology, and Preventive Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - C. Lazar
- Àmbit Prevenció, Barcelona, Spain
| | - L. Ferrer
- Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT) – ICO - Agència de Salut Pública de Catalunya, Badalona, Spain
- Ciber de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | | | - J. Casabona
- Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT) – ICO - Agència de Salut Pública de Catalunya, Badalona, Spain
- Ciber de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Department of Paediatrics, Obstetrics and Gynaecology, and Preventive Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
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22
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Agustí C, Fernàndez-López L, Mascort J, Carrillo R, Aguado C, Montoliu A, Puigdengolas X, De La Poza M, Rifà B, Casabona J. Acceptability of rapid HIV diagnosis technology among primary healthcare practitioners in Spain. AIDS Care 2012; 25:544-9. [PMID: 23061873 DOI: 10.1080/09540121.2012.726339] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study investigated the acceptability of rapid HIV testing among general practitioners (GP) and aimed to identify perceived barriers and needs in order to implement rapid testing in primary care settings. An anonymous questionnaire was distributed online to all members of the two largest Spanish scientific medical societies for family and community medicine. The study took place between 15 June 2012 and 31 October 2010. Completed questionnaires were returned by 1308 participants. The majority (90.8%) of respondents were GP. Among all respondents, 70.4% were aware of the existence of rapid tests for the diagnosis of HIV but they did not know how to use them. Nearly 80% of participants would be willing to offer rapid HIV testing in their practices and 74.7% would be confident of the result obtained by these tests. The barriers most commonly identified by respondents were a lack of time and a need for training, both in the use of rapid tests (44.3% and 56.4%, respectively) and required pre- and post-test counselling (59.2% and 34.5%, respectively). This study reveals a high level of acceptance and willingness on the part of GPs to offer rapid HIV testing in their practices. Nevertheless, the implementation of rapid HIV testing in primary care will not be possible without moving from comprehensive pre-test counselling towards brief pre-test information and improving training in the use of rapid tests.
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Affiliation(s)
- C Agustí
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Institut català d'Oncologia, Agència Salut Pública de Catalunya, Generalitat de Catalunya, Badalona, Spain.
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23
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Manzardo C, Esteve A, Ortega N, Podzamczer D, Murillas J, Segura F, Force L, Tural C, Vilaró J, Masabeu A, Garcia I, Guadarrama M, Ferrer E, Riera M, Navarro G, Clotet B, Gatell JM, Casabona J, Miró JM. Optimal timing for initiation of highly active antiretroviral therapy in treatment-naïve human immunodeficiency virus-1-infected individuals presenting with AIDS-defining diseases: the experience of the PISCIS Cohort. Clin Microbiol Infect 2012; 19:646-53. [PMID: 22967234 DOI: 10.1111/j.1469-0691.2012.03991.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In this prospective, multicentre cohort study, we analysed specific prognostic factors and the impact of timing of highly active antiretroviral therapy (HAART) on disease progression and death among 625 human immunodeficiency virus (HIV)-1-infected, treatment-naïve patients diagnosed with an AIDS-defining disease. HAART was classified as early (<30 days) or late (30-270 days). Deferring HAART was significantly associated with faster progression to a new AIDS-defining event/death overall (p 0.009) and in patients with Pneumocystis jiroveci pneumonia (p 0.017). In the multivariate analysis, deferring HAART was associated with a higher risk of a new AIDS-defining event/death (p 0.002; hazard ratio 1.83; 95% CI 1.25-2.68). Other independent risk factors for poorer outcome were baseline diagnosis of AIDS-defining lymphoma, age >35 years, and low CD4(+) count (<50 cells/μL).
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Affiliation(s)
- C Manzardo
- Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain
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24
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Romero A, Gonzalez V, Esteve A, Martro E, Matas L, Tural C, Pumarola T, Casanova A, Ferrer E, Caballero E, Ribera E, Margall N, Domingo P, Farre J, Puig T, Sauca M, Barrufet P, Amengual M, Navarro G, Navarro M, Vilaro J, Ortin X, Orti A, Pujol F, Prat JM, Massabeu A, Simo JM, Villaverde CA, Benitez MA, Garcia I, Diaz O, Becerra J, Ros R, Sala R, Rodrigo I, Miro JM, Casabona J. Identification of recent HIV-1 infection among newly diagnosed cases in Catalonia, Spain (2006-08). Eur J Public Health 2011; 22:802-8. [DOI: 10.1093/eurpub/ckr179] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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25
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Carnicer-Pont D, Almeda J, Luis Marin J, Martinez C, Gonzalez-Soler MV, Montoliu A, Muñoz R, Casabona J. Unlinked anonymous testing to estimate HIV prevalence among pregnant women in Catalonia, Spain, 1994 to 2009. Euro Surveill 2011; 16:19940. [PMID: 21871221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
This paper estimates the prevalence of human immunodeficiency virus (HIV) infections in women giving birth and women voluntarily terminating pregnancy over a period of sixteen years in Catalonia. Samples for HIV antibody detection were collected from the Neonatal Early Detection Programme for congenital metabolic diseases that covers 99% of infants born in Catalonia. The sampling method collected information of 50% of births every year and of all women attending three clinics for voluntary interruption of pregnancy. Using two sequential immunoassays we analysed unlinked anonymous blood spot samples from 549,689 newborns between 1994 and 2009 and from 31,904 women who voluntarily interrupted pregnancy between 1999 and 2006. HIV prevalence among women giving birth decreased from 3.2 per 1,000 in 1994 to 1.7 per 1,000 in 2009 (p<0.01) and the mean age of infected mothers increased from 26 years in 1994 to 32 years in 2009 (p=0.001). A decrease in HIV prevalence was also observed in women voluntarily terminating pregnancy, from 2.3 per 1,000 in 1999 to 1.0 per 1,000 in 2006 (p<0.01). In contrast, estimated HIV prevalence in mothers born outside Spain increased from 2.2 per 1,000 in 2002 to 3 per 1,000 in 2009 (p<0.01) and their average age increased from 27 years in 2003 to 31 years in 2009 (p<0.01).
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Affiliation(s)
- D Carnicer-Pont
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia, Badalona, Spain.
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26
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Carnicer-Pont D, Almeda J, Luis Marin J, Martinez C, Gonzalez-Soler MV, Montoliu A, Muñoz R, Casabona J, the HIV NADO working group C. Unlinked anonymous testing to estimate HIV prevalence among pregnant women in Catalonia, Spain, 1994 to 2009. Euro Surveill 2011. [DOI: 10.2807/ese.16.32.19940-en] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
This paper estimates the prevalence of human immunodeficiency virus (HIV) infections in women giving birth and women voluntarily terminating pregnancy over a period of sixteen years in Catalonia. Samples for HIV antibody detection were collected from the Neonatal Early Detection Programme for congenital metabolic diseases that covers 99% of infants born in Catalonia. The sampling method collected information of 50% of births every year and of all women attending three clinics for voluntary interruption of pregnancy. Using two sequential immunoassays we analysed unlinked anonymous blood spot samples from 549,689 newborns between 1994 and 2009 and from 31,904 women who voluntarily interrupted pregnancy between 1999 and 2006. HIV prevalence among women giving birth decreased from 3.2 per 1,000 in 1994 to 1.7 per 1,000 in 2009 (p<0.01) and the mean age of infected mothers increased from 26 years in 1994 to 32 years in 2009 (p=0.001). A decrease in HIV prevalence was also observed in women voluntarily terminating pregnancy, from 2.3 per 1,000 in 1999 to 1.0 per 1,000 in 2006 (p<0.01). In contrast, estimated HIV prevalence in mothers born outside Spain increased from 2.2 per 1,000 in 2002 to 3 per 1,000 in 2009 (p<0.01) and their average age increased from 27 years in 2003 to 31 years in 2009 (p<0.01).
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Affiliation(s)
- D Carnicer-Pont
- CIBER, Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Paediatrics, Obstetrics and Gynaecology of the Autonomous University of Barcelona.(UAB), Bellaterra, Spain
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Badalona, Spain
| | - J Almeda
- CIBER, Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Primary Health Department Costa de Ponent, Catalan Health Institute (ICS), IDIAP-Jordi Gol, L’Hospitalet del Llobregat, Spain
| | - J Luis Marin
- The Catalan Neonatal Early Detection Programme, Service of Biochemistry and Molecular Genetics, Hospital Clinic, Faculty of Medicine, Barcelona, Spain
| | - C Martinez
- The Catalan Neonatal Early Detection Programme, Service of Biochemistry and Molecular Genetics, Hospital Clinic, Faculty of Medicine, Barcelona, Spain
| | - M V Gonzalez-Soler
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Badalona, Spain
- CIBER, Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - A Montoliu
- CIBER, Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Badalona, Spain
| | - R Muñoz
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Badalona, Spain
| | - J Casabona
- CIBER, Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Paediatrics, Obstetrics and Gynaecology of the Autonomous University of Barcelona.(UAB), Bellaterra, Spain
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Badalona, Spain
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27
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Sabido M, Lahuerta M, Hernandez G, Montoliu A, Gonzalez V, Giardina F, Monzon JE, Pedroza MI, Casabona J, Guevara R. P1-S2.06 HIV, sexually transmitted infections, and risk behaviours among clients of sex workers in Guatemala - are they a bridge in HIV transmission? Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050108.63] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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28
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Corbeto EL, Lugo R, Martró E, Falguera G, Ros R, Avecilla A, Coll C, Saludes V, Casabona J. Epidemiological features and determinants for Chlamydia trachomatis infection among women in Catalonia, Spain. Int J STD AIDS 2011; 21:718-22. [PMID: 21139152 DOI: 10.1258/ijsa.2010.010223] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We determined the prevalence of Chlamydia trachomatis (CT) infection and risk factors for its acquisition by women aged less than 35 years who were attending sexual health centres in the province of Barcelona in 2007. A convenience sample of 397 adolescents and young adult women aged between 16 and 35 years, stratified by age and recruitment site, were tested using realtime polymerase chain reaction by CT DNA. A standardized questionnaire was used to collect epidemiological and behavioural data on the participants, which were analysed in a multivariate logistic regression model. The overall prevalence of CT was 4%, significantly higher in those under 25 years of age (5.8% versus 1.6% over 25). The independent risk factors for CT infection were: foreign origin (odds ratio [OR] 4.7; confidence interval [CI] 1.02-21.8), having had a sexual partner in the last three months (OR 4.59; CI 1.16-18.08) and tobacco use the last 12 months (OR 6.38; CI 1.16-34.93). In conclusion, this is the first study performed in Catalonia showing a high prevalence of CT in young women, consistent with trends in the rest of Europe. Systematic monitoring of CT infection in sentinel populations such as this will inform future targeted screening programmes in our setting.
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Affiliation(s)
- E L Corbeto
- Center for Epidemiological Studies on HIV/AIDS & STI of Catalonia, ICO/Health Department, Generalitat de Catalunya, Badalona, Spain.
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29
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Lahuerta M, Sabido M, Giardina F, Hernandez G, Palacios JF, Ortiz R, Fernandez VH, Casabona J. Comparison of users of an HIV/syphilis screening community-based mobile van and traditional voluntary counselling and testing sites in Guatemala. Sex Transm Infect 2010; 87:136-40. [DOI: 10.1136/sti.2010.043067] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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30
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Fernàndez-Lopez L, Rifà B, Pujol F, Becerra J, Pérez M, Meroño M, Zaragoza K, Rafel A, Díaz O, Avellaneda A, Casado MJ, Giménez A, Casabona J. Impact of the introduction of rapid HIV testing in the Voluntary Counselling and Testing sites network of Catalonia, Spain. Int J STD AIDS 2010; 21:388-91. [DOI: 10.1258/ijsa.2008.008459] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Summary Rapid HIV antibody tests, which provide results within 15–60 minutes, can help reduce the number of unrecognized infections by improving access to testing facilities and increase the number of people tested who know their results. After an acceptability study, rapid HIV testing was first implemented in Catalonia in 2007 within the community-based Voluntary Counselling and Testing sites network. One year after implementation, an increase of 102.9% has been observed in the number of tests performed, ranging from 8.4% to 328.3% according to the site. Despite the important immediate impact of rapid HIV testing on the number of tests performed, there was no significant change in the proportion of tests that were positive. Rapid HIV testing can help increase access to testing, but it should be complemented with specific outreach programmes targeting the most vulnerable subgroups.
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Affiliation(s)
- L Fernàndez-Lopez
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Institut català d'Oncologia (ICO), DGSP, Generalitat de Catalunya, Badalona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - B Rifà
- Programa de Prevenció i Assistència de la SIDA, DGSP, Generalitat de Catalunya, Barcelona, Spain
| | - F Pujol
- BCN Checkpoint – Projecte dels Noms, Barcelona, Spain
| | - J Becerra
- Associació Ciutadana Anti-Sida de Catalunya, Barcelona, Spain
| | - M Pérez
- Centre Jove d'Anticoncepció i Sexualitat, Barcelona, Spain
| | | | | | - A Rafel
- Associació Anti-Sida de Lleida, Lleida, Spain
| | - O Díaz
- SAPS-Creu Roja, Barcelona, Spain
| | | | - M J Casado
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Institut català d'Oncologia (ICO), DGSP, Generalitat de Catalunya, Badalona, Spain
| | - A Giménez
- Programa de Prevenció i Assistència de la SIDA, DGSP, Generalitat de Catalunya, Barcelona, Spain
| | - J Casabona
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Institut català d'Oncologia (ICO), DGSP, Generalitat de Catalunya, Badalona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
- Departament de Medicina Preventiva i Salut Pública, Universitat Autònoma de Barcelona, Bellaterra, Spain
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Abstract
To evaluate the prevalence of sexual risk behaviours among men who have sex with men (MSM) in Catalonia and to identify sociodemographic, psychosocial, and behavioural factors associated with unprotected anal intercourse (UAI) with casual partners a convenience sample of 850 MSM was recruited in 2006. An anonymous questionnaire was used to explore risk behaviours during the previous 12 months. Logistic regression models were used to examine the variables associated with UAI. Mean age was 41 years and 20.4% were immigrants. Among those with casual partners (91.7% of all respondents), 31.4% had UAI. The multivariate analysis revealed that the likelihood of UAI was higher in men who were HIV-positive (OR: 1.77), used more than four drugs before sex (OR: 4.90 for +6), were not from Spain (OR: 2.10 for Latin American; OR: 1.86 for other immigrants), had more than 20 sexual partners (OR: 1.56), met casual sex partners on the Internet (OR:1.45) and presented a high level of internalised homophobia (OR: 2.40). HIV/STI prevention programmes for MSM in Catalonia should incorporate activities that strengthen self-esteem, take into account the impact of internalised homophobia, and adapt to the sociocultural reality of immigrants. Furthermore, these programmes should also address substance abuse and alert HIV-positive men about the risk of HIV re-infection and transmission of other STI.
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Affiliation(s)
- C Folch
- Centre for Sexually Transmitted Infection and AIDS Epidemiological Studies of Catalonia-ICO, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
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Romero A, Gonzalez V, Granell M, Matas L, Esteve A, Martro E, Rodrigo I, Pumarola T, Miro JM, Casanova A, Ferrer E, Tural C, del Romero J, Rodriguez C, Caballero E, Ribera E, Casabona J. Recently acquired HIV infection in Spain (2003-2005): introduction of the serological testing algorithm for recent HIV seroconversion. Sex Transm Infect 2008; 85:106-10. [DOI: 10.1136/sti.2008.031864] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Navarro G, Nogueras MM, Segura F, Casabona J, Miro JM, Murillas J, Tural C, Ferrer E, Jaén A, Force L, Vilaró J, García I, Masabeu A, Altés J, Esteve A, Sued O, Riera M, Clotet B, Podzamczer D, Gatell JM. HIV-1 infected patients older than 50 years. PISCIS cohort study. J Infect 2008; 57:64-71. [PMID: 18572247 DOI: 10.1016/j.jinf.2008.05.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2008] [Revised: 05/09/2008] [Accepted: 05/10/2008] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The aim of this study is to characterize the ways in which older HIV-infected people differ from younger HIV-infected people. METHODS Prospective cohort study. PISCIS cohort includes newly attended HIV-infected subjects since January 1, 1998. Naive patients were selected. Two groups were defined: G1 (>or=50 years at time of diagnosis, n=493) and G2 (18-49 years, n=4511). Statistical analysis was performed using chi(2), Student's t test, Cox regression and linear mixed models. RESULTS G1 had different features: males (G1: 84% vs. G2: 75%, p<0.001), sexual transmission (52% vs. 32%, p<0.001), AIDS at first visit (38% vs. 22%, p<0.001). The follow-up was 6 years. Ninety-five percent of patients in G1 and 92% in G2 presented a detectable viral load (>or=500 copies/mm(3)) at the first visit (p=0.016). G1 presented lower CD4 levels with respect to G2 throughout the period but the increase of CD4 in G1 at the end of the study period was 254 cells/mm(3) whereas for G2 it was 196 cells/mm(3) (p<0.001). Mortality was 9% for G1 and 4% for G2 (p<0.001). CONCLUSIONS HIV-infected people diagnosed at the age of 50 years or older showed different features. They showed good viral and immunological response to HAART.
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Affiliation(s)
- G Navarro
- Corporación Sanitaria Parc Tauli, Sabadell, Barcelona, Spain.
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Almeda J, Casabona J, Matas L, González V, Muga R, Sanz B, Bolao F, Ausina V. Evaluation of a commercial enzyme immunoassay for HIV screening in urine. Eur J Clin Microbiol Infect Dis 2004; 23:831-5. [PMID: 15480885 DOI: 10.1007/s10096-004-1221-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A cross-sectional study was conducted to evaluate the utility of a commercial enzyme immunoassay (EIA) as a screening test for detecting HIV-1 antibody in urine in a population at risk for HIV infection in Catalonia, Spain. Paired urine and serum samples were collected consecutively from 99 patients who attended two drug-dependency treatment centres and 151 patients who attended a sexually transmitted diseases (STD) clinic in Barcelona. Antibodies against HIV in urine samples were detected using the Calypte HIV-1 Urine EIA (Calypte Biomedical Corporation, Berkeley, CA, USA) and confirmed by urine-based Western blot (WB) analysis. Sera were analysed using Bioelisa HIV-1+2 EIA (Biokit Laboratories, Barcelona, Spain), and the results were verified using serum-based WB analysis. Results of both urine and serum testing were available for 246 of 250 participants. For 52 individuals the results of both urine and serum testing were positive and for five the results were discordant (2 with urine-negative/serum-positive results and 3 with urine-positive/serum-negative results). The respective sensitivity and specificity values obtained for the urine EIA were 100% and 96.2% for intravenous drug users (IDUs) and 80% and 99.3% for persons attending the STD clinic. According to the 1997 UNAIDS/WHO strategy I recommendations, these values are acceptable for surveillance purposes, particularly in populations with a high prevalence of HIV infection.
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Affiliation(s)
- J Almeda
- Centre for Epidemiological Studies on HIV/AIDS in Catalonia, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet s/n, 08916 Badalona, Spain.
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Almeda J, Casabona J, Simon B, Gerard M, Rey D, Puro V, Thomas T. Proposed recommendations for the management of HIV post-exposure prophylaxis after sexual, injecting drug or other exposures in Europe. Euro Surveill 2004; 9:35-40. [PMID: 15223890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
Post-exposure prophylaxis (PEP) is the standard of care for a healthcare worker (HCW) accidentally exposed to an HIV infected source person (occupational exposure), but this is not the case for non-occupational exposures. Very few national guidelines exist for the management of non-occupational exposures to HIV in Europe, contrarily to the occupational ones. The administration of non-occupational post-exposure prophylaxis (NONOPEP) for HIV may be justified by: a biological plausibility, the effectiveness of PEP in animal studies and occupational exposures in humans, efficacy in the prevention of mother to child HIV transmission, and cost effectiveness studies. These evidences, the similar risk of HIV transmission for certain non-occupational exposures to occupational ones, and the conflicting information about attitudes and practices among physicians on NONOPEP led to the proposal of these European recommendations. Participant members of the European project on HIV NONOPEP, funded by the European Commission, and acknowledged as experts in bloodborne pathogen transmission and prevention, met from December 2000 to December 2002 at three formal meetings and a two day workshop for a literature review on risk exposure assessment and the development of the European recommendations for the management of HIV NONOPEP. NONOPEP is recommended in unprotected receptive anal sex and needle or syringe exchange when the source person is known as HIV positive or from a population group with high HIV prevalence. Any combination of drugs available for HIV infected patients can be used as PEP and the simplest and least toxic regimens are to be preferred. PEP should be given within 72 hours from the time of exposure, starting as early as possible and lasting four weeks. All patients should receive medical evaluation including HIV antibody tests, drug toxicity monitoring and counseling periodically for at least 6 months after the exposure. NONOPEP seems to be a both feasible and frequent clinical practice in Europe. Recommendations for its management have been achieved by consensus, but some remain controversial, and they should be updated periodically. NONOPEP should never be considered as a primary prevention strategy and the final decision for prescription must be made on the basis of the patient-physician relationship. Finally, a surveillance system for these cases will be useful to monitor NONOPEP practices in Europe.
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Affiliation(s)
- J Almeda
- CEESCAT, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
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Ramos F, García-Fructuoso MT, Almeda J, Casabona J, Coll O, Fortuny C. [Determinants of HIV mother-to-child transmission in Catalonia, Spain [1997-2001]: is it possible to eliminate it?]. Gac Sanit 2003; 17:275-82. [PMID: 12975050 DOI: 10.1016/s0213-9111(03)71747-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To identify and describe the factors that have led to new cases of HIV infection through mother-to-child transmission since the introduction of antiretroviral therapy in HIV-seropositive pregnant women (1997-2001) in Catalonia. METHODS Systematic review of cases identified in the pediatric services of all the hospitals in Catalonia. RESULTS Twenty-eight cases of pediatric HIV infection were identified: 9, 9, 8, 2 and 0 per year of birth from 1997 to 2001, respectively. Of 16 mothers with a diagnosis of known HIV infection before or during pregnancy, nine underwent antiretroviral prophylaxis during pregnancy (compliance was good in five, unknown in one and poor in one) and seven did not undergo prophylaxis (six refused it and no information was available in one). Of 12 mothers diagnosed after delivery, pregnancy was not monitored in five and was little or well-monitored in the remaining seven. Of mothers with well-monitored pregnancy, a serological HIV test was not performed in six and was negative in the first trimester in one. CONCLUSIONS Mother-to-child transmission of HIV has decreased in the last few years in Catalonia, but infections have sometimes occurred through poor implementation of preventive measures. Pregnant women should be offered an HIV diagnostic test not only in the first trimester but also at the end of pregnancy if HIV exposure is suspected. In women with unmonitored pregnancies, rapid diagnostic tests for HIV should be used in the delivery room.
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Affiliation(s)
- F Ramos
- CEESCAT. Hospital Universitari Germans Trias i Pujol. Badalona. Barcelona. Spain
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37
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Casabona J, Romaguera A, Almeda J, Blanch C, Caylà JA, Miró JM, Colom J. [Reporting new HIV cases in Catalonia, Spain: is technical consensus feasible?]. Gac Sanit 2003; 17:75-82. [PMID: 12605750 DOI: 10.1016/s0213-9111(03)71695-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To describe the process performed in Catalonia (Spain) to design an information system for monitoring new cases of HIV infection. METHODS A survey was used to evaluate perception of the need for notification of HIV infection by health care professionals (n = 106), as well as their opinions of the various possibilities for the implementation of the notification system. As a result of this evaluation, a specific technical report defining the objectives and technical characteristics of the new notification system was produced. The feasibility of the system in health centres was evaluated through discussions with health care professionals, health authorities and Non-Governmental Organizations, and a second survey was designed to evaluate the use of a personal identification code (PIC) from the individual health card (IHC). This process took plabe between 1998 and 2000. RESULTS A total of 84.5% of the health care professionals believed that HIV notification should be mandatory and confidential; 90.4%, were of the opinion that notification would enable identification of the epidemiological characteristics of infected individualos, and 75% believed that these individuals would have to be identified by name. Finally, 66% of the health care professionals believed that the use of the PIC from the IHC would be feasible as the personal identifier in HIV notification. A final proposal was draw up and 1 January, 2001 was set as the date to initiate the pilot phase of the new HIV notification system. CONCLUSIONS Most of the health care professionals surveyed expressed the need for notification of HIV infection, and for such notification to receive institutional endorsement. They also believed that, as with other diseases of individualized mandatory reporting, notification should be carried out with a single personal identifier. The information obtained from notification of HIV infection is essential for the optimal planning of preventive programs and the provision of health services. The main difficulties observed were that HIV infection has not been included among the diseases of mandatory reporting, as well as the low implantation of the PIC in the hospitals' clinical registries. All the sectors involved have an important role to play in creating the conditions necessary for the notification system of new cases of HIV infection to be feasible and useful.
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Affiliation(s)
- J Casabona
- Centre d'Estudis Epidemiològics sobre la Sida de Catalunya (CEESCAT), Badalona, Barcelona. España.
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Abstract
Recently, different studies among men who have sex with men (MSMs) have reported an increase in HIV incidence and sexually transmitted infections, and an increase in sexual risk behaviour. But the optimism regarding anti-retroviral treatments may lead to a greater relaxation in protective measures in the near future.
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Affiliation(s)
- K Pérez
- Centre for Epidemiological Studies on AIDS of Catalonia (CEESCAT), Badalona, Spain
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39
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Gambús G, Bourboulia D, Esteve A, Lahoz R, Rodriguez C, Bolao F, Sirera G, Muga R, del Romero J, Boshoff C, Whitby D, Casabona J. Prevalence and distribution of HHV-8 in different subpopulations, with and without HIV infection, in Spain. AIDS 2001; 15:1167-74. [PMID: 11416719 DOI: 10.1097/00002030-200106150-00012] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To estimate the seroprevalence of HHV-8 in several Spanish subpopulations with different risk levels of acquiring HIV-1 infection and from different geographical regions. DESIGN Cross-sectional seroprevalence study. METHODS A total of 1699 serum samples from blood donors (613), children under the age of 12 years (100), injecting drug users (IDU) (382), heterosexuals attending a sexually transmitted disease (STD) clinic (273) and homosexual men attending a STD clinic or a HIV-based hospital unit (331) were analysed for anti-HHV-8 antibodies. The presence of antibodies against HHV-8 was tested with an indirect immunofluorescence assay (IFA). A subsample of HHV-8-positive samples was also tested for antibody titre against HHV-8. RESULTS The overall seroprevalence of antibodies against HHV-8 for the blood donor population was 6.5% (7.0% in Andalusia, 8.0% in Catalonia and 4.5% in the Basque Country). None of the children tested positive for HHV-8. The HHV-8 prevalence was 86.7% in HIV-positive homosexual men and 28.0% in HIV-negative homosexual men (P < 0.001). Of heterosexual men attending STD clinics, 17.2% tested positive for HHV-8; 11.5% of IDU tested positive for HHV-8. HHV-8 antibody titres by groups parallel the distribution of HHV-8 prevalence. No association between HHV-8 antibody titres and CD4 cell count or HIV viral load was identified. CONCLUSIONS The HHV-8 prevalence among blood donors in Spain is higher than in Northern Europe and the USA, but is similar to that in Northern Italy. The distribution of HHV-8 is compatible with a sexually transmitted agent. The distribution of HHV-8 correlates with that of Kaposi's sarcoma but factors other than HHV-8 seem to explain the Kaposi sarcoma distribution.
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Affiliation(s)
- G Gambús
- Centre for Epidemiological Studies on HIV/AIDS in Catalonia (CEESCAT), Hospital Universitari Germans Trias i Pujol, Badalona, Spain
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Abstract
Injecting drug users (IDUs) should be considered a 'partially hidden population' at high risk for HIV infection. In almost all locations it should be possible to locate and conduct research with IDUs, but it will probably never be possible to enumerate or draw random samples from an IDU population. Surveillance research studies with IDUs should include risk behaviors, as surveillance of HIV infection only will not be sufficiently time sensitive, and be used to develop and refine HIV prevention programming for the population. Contacts with IDUs can be developed at multiple settings, including voluntary treatment programs, law enforcement settings, and through 'street outreach.' Each type of setting has different advantages, disadvantages and ethical concerns. HIV testing as part of surveillance also raises additional important ethical concerns. The primary risk behaviors that should be included in surveillance studies are 'sharing' of drug injection equipment, the potential for rapid partner change among risk partners, and sexual risk behavior. Additional important objectives for surveillance research include: (1) the size of the local IDU population, (2) patterns of drug use, (3) availability injection equipment, (4) participation in prevention activities, and (5) access to and use of anti-retroviral treatments. HIV incidence is an ultimate objective for surveillance research, but there are no currently available cost-efficient methods for studying HIV incidence, so estimation from indirect measurements is usually required.
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Affiliation(s)
- D C Des Jarlais
- Edmond de Rothschild Foundation, Chemical Dependency Institute, Beth Israel Medical Center, 1st Avenue and 16th Street, New York, NY 10003, USA.
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Mayans MV, Maguire A, Miret M, Casabona J. Disproportionate high incidence of invasive cervical cancer as an AIDS-indicative disease among young women in Catalonia, Spain. Sex Transm Dis 1999; 26:500-3. [PMID: 10534202 DOI: 10.1097/00007435-199910000-00003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Spain has the highest rate of AIDS in Europe since 1990, mainly at the expenses of the intravenous drug user (IDU) transmission group, and women account for 20% of all the cases. Because cervical lesions may be altered by HIV, invasive cervical cancer (ICC) is included in the AIDS case definition worldwide. GOAL OF STUDY To assess the impact of the HIV epidemic on the incidence of ICC and to describe the characteristics of ICC in the spectrum of AIDS-defining diseases in Catalonia, Spain. STUDY DESIGN Descriptive study of women notified through the AIDS surveillance system during 1994 to 1996. Age-specific ICC incidence rates from a population-based Cancer Registry were used to calculate the population attributable risk percent (PAR%). RESULTS Fifty-six cases (6.8%) with ICC were reported to the AIDS Registry, 64.3% of those women were IDU with a mean age of 32. Among women aged 20 to 49, the PAR% was 12.2% (95% CI: 7.9-16.5%) and the incidence rate ratio was 18.5 (95% CI: 11.2-29.2). CONCLUSIONS HIV is having an impact on ICC epidemiology among young women in Catalonia. The policy of cervical screening should be modified and offered every 6 to 12 months to women at risk for or with HIV infection.
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Affiliation(s)
- M V Mayans
- Centre for Epidemiological Studies on AIDS in Catalonia, University Hospital Germans Trias i Pujol, Badalona, Spain
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42
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Casabona J. [AIDS or HIV infection? The health care implications]. Med Clin (Barc) 1999; 112:335-6. [PMID: 10220765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Blanch C, Vall M, Matas L, Sánchez D, Casabona J. [The epidemiological surveillance of human immunodeficiency virus (HIV) infection in a hospital population of Catalonia. Collaborators in the VIHHOSP project]. Med Clin (Barc) 1998; 111:731-5. [PMID: 9922955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
BACKGROUND AIDS is one of the most important problems of public health in our setting. The surveillance of HIV infection in sentinel population is an important alternative to the use of the AIDS cases registries, to obtain a dynamic and updated information about HIV/AIDS epidemic. The objective of this study was to determine the prevalence of HIV infection among the patients from 5 sentinel hospitals in Catalonia, Spain. PATIENTS AND METHODS Unlinked anonymous screening of serum from patients aged 15-49 from 5 sentinel hospitals in Catalonia, Spain. Samples were broken by age, sex, in-patients or out-patients and clinical specialities related to HIV/AIDS or not related. Samples were analyzed in pools of five and were tested by the OMS strategy II, for the epidemiological surveillance purposes. RESULTS HIV testing was developed in 9,524 patients, with a prevalence of 1.6% (153 samples). The overall prevalence in men was twice that of women (2.3% vs. 1.1%). Ages between 25 to 34 had the higher prevalence (3.1%). Clinical specialities related with HIV/AIDS had a prevalence twice that of non related (2.3% vs. 1.2%). CONCLUSIONS The HIV prevalence found in this population is the highest compared to similar studies performed in other western european countries. Our data confirm the pattern of HIV infection for age and sex observed in other studies in Catalonia, Spain. This is the first study of sentinel surveillance in sentinel hospitals in Spain and give us the base line which will serve as a reference to assess the evolution of HIV infection in further studies in sentinel hospital populations in Catalonia.
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Affiliation(s)
- C Blanch
- Centre d'Estudis Epidemiològics sobre la SIDA de Catalunya (CEESCAT), Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona
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Domingo-Salvany A, Hartnoll RL, Maguire A, Brugal MT, Albertín P, Caylà JA, Casabona J, Suelves JM. Analytical considerations in the use of capture-recapture to estimate prevalence: case studies of the estimation of opiate use in the metropolitan area of Barcelona, Spain. Am J Epidemiol 1998; 148:732-40. [PMID: 9786228 DOI: 10.1093/oxfordjournals.aje.a009694] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Capture-recapture, an indirect method widely used to estimate undetected populations, has been criticized because it causes problems due to a lack of compliance with several important assumptions and model selection strategies. This paper expands on the problems encountered when applying this methodology to drug abuse estimations, specifically the prevalence of opiate use in the metropolitan area of Barcelona, Spain, in 1993. Three samples of opiate users (from hospital emergency rooms, treatment centers, and prisons) were available in the area studied; an additional sample (mortality data) was analyzed for the city of Barcelona. Log-linear models that provided a good fit were considered, to which further model selection strategies were applied. A total of 3,207 unique individuals aged 15-44 years were identified in the three samples from the greater Barcelona area; the mortality sample from the city of Barcelona contained an additional 83 individuals. Heterogeneity was observed in different age, sex, and residence area subgroups. Population estimates differed widely according to the log-linear model chosen. Minimum Akaike's information criterion model and saturated model estimates were used to produce population prevalence rates. The main problems the authors encountered in this study were related to population definition, source heterogeneity, and assessment of an adequate model, a problem associated with sample size.
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45
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Rodés A, Vall M, Casabona J, Nuez M, Rabella N, Mitrani L. [Prevalence of human immunodeficiency virus infection and behaviors associated with its transmission among parenteral drug users selected on the street]. Med Clin (Barc) 1998; 111:372-7. [PMID: 9833239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND To estimate the prevalence of HIV infection and the associated risk behaviours among intravenous drug users not receiving treatment for their drug dependence. PATIENTS AND METHODS A cross-sectional study of 200 intravenous drug users recruited from the streets of Barcelona in 1993. Information about the socio-demographic aspects and behaviours was obtained through a personal interview using a standardised questionnaire which was carried out by three ex-drug users. Saliva samples were used to determine anti HIV antibodies. RESULTS The prevalence of HIV infection was 51%. 57% borrowed used syringes, 65% lended their syringes, and 41% practised back of frontloading. 85% if those who shared syringes always cleaned them, however 59% only used water. 78% had heterosexual relations, in 33% of the cases with a non-injecting sexual partner. 65% always used condoms with sexual clients although only 26% always used them with stable sexual partners and 36% with casual sexual partners. 78% had performed the HIV test and among those who knew they were seropositive, 40% had received some kind of health control in the last 6 months. Not having a legal income, injecting speedball or barbiturates, unknowing self HIV negative status and practicing forms of indirect sharing were found to be independently associated with syringe sharing. CONCLUSIONS The high prevalence of HIV infection and associated risk behaviours highlights the need to increase and adapt the prevention efforts and investigation to this group. Social marginalization and poliuse of drugs should be addressed in HIV prevention programs.
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Affiliation(s)
- A Rodés
- Centro de Estudios Epidemiológicos sobre el Sida de Cataluña, Hospital Universitario Germans Triaś i Pujol, Badalona.
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Vall Mayans M, Maya A, Matas L, Casabona J. [Prevalence of maternal HIV infection in Catalonia (1994): results of non-related anonymous neonatal screening. VIHNADO Group]. Med Clin (Barc) 1998; 110:128-31. [PMID: 9541901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Spain has the highest incidence rate of AIDS in Europe. Catalonia contributes with around 30% of the AIDS cases detected in Spain. From 1990 to 1994 the AIDS heterosexual transmission category increased from 9.6% to 14.6% in Catalonia. The objective of the study was to determine the HIV prevalence in a heterosexual population of pregnant women. SUBJECTS AND METHODS Unlinked anonymous HIV screening by means of an agglutination assay and an enzyme immunoassay of eluates of dried blood spots from nearly half of the neonates born in Catalonia during 1994. RESULTS HIV testing was done on 21,074 neonates. Overall HIV prevalence was 0.32% (95% CI: 0.25-0.40). It varied from 0.45% in Barcelona, 0.38-0.29% in the health regions around Barcelona, to 0.20-0.09% in the rest. The mean age of HIV infected women was younger (27) than that of the seronegative ones (29) (p < 0.001). The highest prevalence was 0.61% in women aged 20-24 years. CONCLUSIONS The HIV prevalence in the heterosexual population of pregnant women in Catalonia is among the highest in Europe. Preventive efforts must begin with schoolchildren and be directed to adolescents and young women. It is convenient that women who want to become pregnant and mothers receiving antenatal care have access to voluntary confidential HIV testing.
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Affiliation(s)
- M Vall Mayans
- Centre d'Estudis Epidemiològics sobre la Sida de Catalunya, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona
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Abstract
CCR5, a chemokine receptor, serves as a coreceptor for macrophage-tropic HIV-1 (1-3). A 32-bp deletion within the gene encoding CCR5, CCR5del32, has been shown to prevent HIV-1 infection of T cells in the absence of a wild-type allele. This alteration is present in low frequency in Caucasian populations (4-6). To investigate the effect of CCR5del32 in perinatal HIV-1 transmission and disease progression, two cohorts of perinatally exposed infected and uninfected children were analyzed for the presence of the allele. Polymerase chain reaction (PCR) was used to identify CCR5del32 in prevalent and prospective cases among 144 African American children from New York City and 73 Caucasian children from Barcelona, Spain. HIV-1 transmission; clinical manifestations of disease, including encephalopathy, opportunistic infections, and death before 2 years of age; survival; Centers for Disease Control and Prevention (CDC) classification; and degree of immunosuppression were compared in children with and without CCR5del32. The allele frequency in HIV-1-infected African Americans (0.016) was lower than in Catalan children (0.041). No evidence for a dominant protective effect of CCR5del32 for HIV-1 transmission or disease progression was found in these cohorts.
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Affiliation(s)
- C M Rousseau
- Division of Medical Genetics, University of Washington, Seattle 98195-7720, USA.
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Maguire A, Sánchez E, Fortuny C, Casabona J. Potential risk factors for vertical HIV-1 transmission in Catalonia, Spain: the protective role of cesarean section. The Working Group on HIV-1 Vertical Transmission in Catalonia. AIDS 1997; 11:1851-7. [PMID: 9412704 DOI: 10.1097/00002030-199715000-00010] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To evaluate the roles of certain potential risk factors on the vertical transmission of HIV-1. DESIGN Prospective registry of infants born to HIV-1-infected women in Catalonia (north-east Spain) from 1987 to 1992. METHODS A total of 599 infants, born in Catalan hospitals to 520 women who were identified as being HIV-1-infected during gestation or at delivery, were included. Data on mode of delivery, birth weight, gestational age and breast-feeding as well as the mother's age, her route of HIV-1 infection, clinical stage and p24 antigenaemia, were recorded. HIV-1 infection status of 489 (82%) of the infants was determined according to the criteria of the US Centers for Disease Control and Prevention. Risk estimates and odds ratio (OR) were calculated and logistic regression was performed. RESULTS The overall rate of vertical transmission was 18.6% (95% confidence interval, 15.2-22.0%). Multivariate analyses revealed that Cesarean section was associated with a lower rate of vertical transmission (OR = 0.3; P = 0.001), as was maternal HIV-1 infection via injecting drug use (OR = 0.44; P = 0.02). Breast-feeding (OR = 6.9; P = 0.001), very low birth weight (< 1500 g; OR = 6.3; P = 0.001) and p24 antigenaemia (OR = 4.6; P = 0.04) were all related to increased risk. The crude rate of HIV-1 transmission was 6% among Cesarean births compared with 21% for infants born via vaginal deliveries. The population-attributable risk for vaginal deliveries was 61.7%. CONCLUSIONS The results show a protective effect of Cesarean section in the absence of zidovudine prophylaxis. However, current research should be directed towards the individual and combined effects that antiretroviral agents and Cesarean section may have on mother-to-child HIV-1 infection.
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Affiliation(s)
- A Maguire
- Centre for Epidemiological Studies on AIDS in Catalonia CEESCAT, Hospital Universitari Germans Trias i Pujol, Badalona
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Blanch C, Vall M, Casabona J. [Analysis of the microbiological information derived from the sentinel laboratory network for the monitoring of the human immunodeficiency virus infection in Catalonia (1989-1995)]. Enferm Infecc Microbiol Clin 1997; 15:401-6. [PMID: 9424118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The epidemiologic information on AIDS derived exclusively from the AIDS case registry presents a series of limitations. To solve some of these epidemiologic surveillance systems of HIV infection have been designed. The information of the microbiology laboratories in which anti-HIV antibody detection tests are performed has been one of the most commonly used sources of information. MATERIAL AND METHOD The detection activity of the anti-HIV antibodies from a surveillance laboratory network in Catalonia from 1989 to 1995 was collected. RESULTS A continuous increase was observed in the number of tests performed in the network laboratories (30012 in 1989 up to 63323 in 1995) as was a significant decrease in the number of tests which were reactive (20.7% in 1989 to 6.1% in 1995). Great variability was found in the results among the different laboratories as well as in the diagnostic algorythms used. CONCLUSIONS Laboratories are an important source to take into account to perform epidemiologic surveillance of HIV infection. The collaboration among the laboratories and public health care officials allows information to be obtained that aids in better defining the characteristics of people who currently have HIV infection and in designing preventive activities directed at the needs of each community. This collaboration also allows homogeneous diagnostic algorythmns and common criteria to be established to ensure quality control.
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Affiliation(s)
- C Blanch
- Centre d'Estudis Epidemiològics sobre la VIH/sida a Catalunya (CEESCAT), Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona
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Abstract
A cross-sectional survey to assess the impact of the paediatric HIV/AIDS epidemic on the hospital-based health care system was performed in state-financed hospitals in Catalonia during 1992, raising issues of relevance today. Out of the 27 hospitals contacted, 20 responded. A considerable proportion of the health care to children with an HIV-related condition was provided by four hospitals. The average length of stay of the 176 HIV patients who were admitted was 10.8 days; these patients were admitted to the hospital twice a year on average. Nearly half of the out-patients who attended with an HIV-related condition were either seropositive without a confirmed diagnosis of an HIV infection (class P-0) or seronegative. Thirteen per cent of the overall admissions to paediatric day care hospitals were attributable to an HIV-related condition. By ownership status of the hospitals, HIV/AIDS paediatric in-patients of public hospitals generated the majority of admissions per patient per year, and had the shortest lengths of stay. Unlike the HIV/AIDS epidemic in adults, the magnitude and characteristics of the epidemic in children may not require the shift of hospital-based health care to primary health care.
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Affiliation(s)
- M Miret
- Centre d'Estudis Epidemiològics sobre la Sida a Catalunya (CEESCAT), Badalona, Spain
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