Patricia Garcia de Olalla
Public Health Agency of Barcelona, Spain
Title: Does the high prevalence of late presentation of HIV infection persist?
Biography
Biography: Patricia Garcia de Olalla
Abstract
Background & Aim: Early diagnosis of HIV infection and its treatment improves health of patients and is essential to prevent HIV transmission. The aim of this study was to determine the prevalence, describe the trend and identify the factors associated with late presentation (LP) of HIV-infection in Barcelona during the period 2013-2015.
Methods: We analyzed the cases included in the register of HIV-infection. LP were defined as persons presenting for care with a CD4 count below 350 cells/μl or with an AIDS-defining event at the time of HIV diagnosis or within 6 months of the positive test, regardless of the CD4 cell count. Multivariate logistic regression was used to identify predictors of LP.
Results: Of the 1,115 cases studied, 479 (43.0%, 95% confidence interval (CI): 40.1%-45.9%) were LP. The prevalence of LP was 42.4% in 2013, 42.5% in 2014, 44.0% in 2015 (p=0.65). 39.6% (341 cases) of men who has sex with men (MSM) were LP, 60.2% (65 cases) of the heterosexual men (HTM) and 61% (22 cases) of the injecting drug users (IDU). After adjusting for place of birth and year of diagnosis, LP was more frequent in those older than 29 years (between 30 and 49 years old Odds ratio (OR): 1.4; CI: 1.1-1.8; older than 49 years old; OR: 2.5; CI: 1.2-5.38), in HTM and IDU when compared to MSM (OR: 2.5; CI: 1.2-5.38, and OR : 1.9, CI: 1.3-2.9, respectively), and in those reported from hospitals (OR: 2.1; CI: 1.3-3.2) when compared with those from units of sexually transmitted infections.
Conclusion: LP in 2015 remains at levels of previous years and continues to be very high in all transmission groups despite initiatives to increase access to HIV testing in our city. It is necessary to improve and develop new interventions that are more efficient for an early diagnosis of HIV.