BMC Infectious Diseases
Volume 15, Issue 1, 2015

Good continuum of HIV care in Belgium despite weaknesses in retention and linkage to care among migrants (Article) (Open Access)

Van Beckhoven D.* , Florence E. , Ruelle J. , Deblonde J. , Verhofstede C. , Callens S. , Vancutsem E. , Lacor P. , Demeester R. , Goffard J.-C. , Sasse A. , De Wit S. , Vogelaers D. , Delforge M.-L. , Fransen K. , Hayette M.-P. , Legrand J.-C. , Moutschen M. , Piérard D. , Vaira D. , Vandekerckhove L. , Van den Wijngaert S. , Vandercam B. , Van Ranst M. , Van Wijngaerden E. , For the BREACH (Belgian Research on AIDS and HIV Consortium)
  • a Scientific Institute of Public Health, Epidemiology of Infectious Diseases Unit, Rue J. Wytsman 14, Brussels, 1050, Belgium
  • b Instituut Tropische Geneeskunde, Department of Clinical Sciences, Antwerp, Belgium; ARC ITG, Belgium
  • c Institute of Experimental and Clinical Research (IREC), Unit of Medical Microbiology (MBLG), Université Catholique de Louvain, Brussels, Belgium; ARL UCL, Belgium
  • d Scientific Institute of Public Health, Epidemiology of Infectious Diseases Unit, Rue J. Wytsman 14, Brussels, 1050, Belgium
  • e Ghent University, AIDS Reference Laboratory, Department of Clinical Chemistry, Microbiology and Immunology, Ghent, Belgium; ARL UZ Gent, Belgium
  • f Universitair Ziekenhuis Gent, Department of Internal Medicine, Ghent, Belgium
  • g Universitair Ziekenhuis Brussel, Department of Microbiology and Infection Control, Brussels, Belgium
  • h Universitair Ziekenhuis Brussel, Department of Internal Medicine, Brussels, Belgium; ARC UZ Brussel, Belgium
  • i CHU de Charleroi, Department of Internal Medicine and Infectious Diseases, Charleroi, Belgium
  • j Service of Internal Medicine, Hôpital Erasme, Brussels, Belgium; ARC Hôpital Erasme, Belgium
  • k Scientific Institute of Public Health, Epidemiology of Infectious Diseases Unit, Rue J. Wytsman 14, Brussels, 1050, Belgium
  • l ARC CHU Saint-Pierre, Belgium
  • m ARC UZ Gent, Belgium
  • n ARL Hôpital Erasme, Belgium
  • o ARL ITG, Belgium
  • p ARL CHU Liège, Belgium
  • q ARC CHU Charleroi, Belgium
  • r ARC CHU Liège, Belgium
  • s ARL UZ Brussel, Belgium
  • t ARL CHU Liège, Belgium
  • u ARC UZ Gent, Belgium
  • v ARL Hôpital Saint-Pierre, Belgium
  • w ARC Cliniques Universitaires Saint-Luc, Belgium
  • x ARL KUL, Belgium
  • y ARC UZ Leuven, Belgium
  • z [Affiliation not available]

Abstract

Background: The Belgian HIV epidemic is largely concentrated among men who have sex with men and Sub-Saharan Africans. We studied the continuum of HIV care of those diagnosed with HIV living in Belgium and its associated factors. Methods: Data on new HIV diagnoses 2007-2010 and HIV-infected patients in care in 2010-2011 were analysed. Proportions were estimated for each sequential stage of the continuum of HIV care and factors associated with attrition at each stage were studied. Results: Of all HIV diagnosed patients living in Belgium in 2011, an estimated 98.2 % were linked to HIV care, 90.8 % were retained in care, 83.3 % received antiretroviral therapy and 69.5 % had an undetectable viral load (<50 copies/ml). After adjustment for sex, age at diagnosis, nationality and mode of transmission, we found lower entry into care in non-Belgians and after preoperative HIV diagnoses; lower retention in non-Belgians and injecting drug users; higher retention in men who have sex with men and among those on ART. Younger patients had lower antiretroviral therapy uptake and less viral suppression; those with longer time from diagnosis had higher ART uptake and more viral suppression; Sub-Saharan Africans on ART had slightly less viral suppression. Conclusions: The continuum of HIV care in Belgium presents low attrition rates over all stages. The undiagnosed HIV-infected population, although not precisely estimated, but probably close to 20 % based on available survey and surveillance results, could be the weakest stage of the continuum of HIV care. Its identification is a priority along with improving the HIV care continuum of migrants. © 2015 Van Beckhoven et al.

Author Keywords

Migrants Continuum of care HIV Cascade Belgium

Index Keywords

patient care HIV Infections Africa south of the Sahara Human immunodeficiency virus infection human highly active antiretroviral therapy trend study Viral Load statistics and numerical data Anti-Retroviral Agents antiretrovirus agent Health Surveys ethnology men who have sex with men Humans Black person African Continental Ancestry Group male CD4 lymphocyte count female Belgium Continuity of Patient Care Article epidemic major clinical study adult migration drug abuse health care quality age virus load drug use patient attitude Drug Users Patient Acceptance of Health Care health care system Transients and Migrants virus inhibition health survey
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84959200314&doi=10.1186%2fs12879-015-1230-3&partnerID=40&md5=8e59f623bfa8a99952b2bf3845930dbc
DOI: 10.1186/s12879-015-1230-3
ISSN: 14712334
Cited by: 16
Original Language: English