Effects of region of birth, educational level and age on late presentation among men who have sex with men newly diagnosed with HIV in a network of STI/HIV counselling and testing clinics in Spain

This paper analyses late presentation (LP) of HIV infection, and its determinants, among men who have sex with men (MSM) in Spain, newly diagnosed with HIV (2003-2011) in 15 sexually transmitted infection/HIV counselling and testing clinics. LP was defined as <350 CD4 cells/µL or AIDS. In total,...

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Detalles Bibliográficos
Autores: Diaz Franco, Asuncion, Del Romero, Jorge, Rodriguez, C, Alastrue, I, Belda, J, Bru, F J, Cámara, M M, Junquera, M L, Sanz, I, Viloria, L J, Gil, L, Martínez, E, Gual, F, Landa, M C, Pueyo, I, Ureña, José Manuel, Martínez, B, Varela, J A, Polo, A, Azpiri, M A, Diez Ruiz-Navarro, Mercedes, EPI-VIH Study Group
Tipo de recurso: artículo
Fecha de publicación:2015
País:España
Institución:Instituto de Salud Carlos III (ISCIII)
Repositorio:Repisalud
Idioma:inglés
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/9002
Acceso en línea:http://hdl.handle.net/20.500.12105/9002
Access Level:acceso abierto
Palabra clave:Adult
Africa
Age of Onset
Community Health Centers
Counseling
Educational Status
HIV Infections
Humans
Latin America
Male
Middle Aged
Sexual Partners
Sexually Transmitted Diseases
Spain
Delayed Diagnosis
Homosexuality, Male
Descripción
Sumario:This paper analyses late presentation (LP) of HIV infection, and its determinants, among men who have sex with men (MSM) in Spain, newly diagnosed with HIV (2003-2011) in 15 sexually transmitted infection/HIV counselling and testing clinics. LP was defined as <350 CD4 cells/µL or AIDS. In total, 3,081 MSM were included (2,499 having CD4/AIDS); overall LP was 25.3%. LP was higher in men older than 34 years, those not previously HIV-tested (adjusted odds ratio (aOR):3.1; 95% confidence intervals (CI):2.3-4.2) , and those tested > 12 months before diagnosis (12-24 months (aOR:1.4; 95% CI:1.0-2.0); > 24 months (aOR:2.2; 95% CI:1.7-3.0)). LP was less likely in MSM reporting a known HIV-infected partner as infection source or symptoms compatible with acute retroviral syndrome. 'Region of birth' interacted with 'educational level' and 'steady partner as infection source': only African and Latin-American MSM with low educational level were more likely to present late; Latin-American men attributing their infection to steady partner, but no other MSM, had LP more frequently. In Spain, HIV testing among MSM should be promoted, especially those > 34 years old and migrants with low educational level. The current recommendation that MSM be tested at least once a year is appropriate.

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