Epidemiology and Infection
Volume 145, Issue 8, 2017, Pages 1670-1681

Differences between migrants and Spanish-born population through the HIV care cascade, Catalonia: An analysis using multiple data sources (Article) (Open Access)

Reyes-Urueña J.* , Campbell C. , Hernando C. , Vives N. , Folch C. , Ferrer L. , Fernández-López L. , Esteve A. , Casabona J.
  • a Centre for Epidemiological Studies on HIV/STI of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain, Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain, Department Paediatrics, Obstetrics and Gynaecology, Preventive Medicine, Univ Autonoma de Barcelona, Bellaterra, Spain
  • b Centre for Epidemiological Studies on HIV/STI of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain, Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
  • c Centre for Epidemiological Studies on HIV/STI of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain, Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain, Department Paediatrics, Obstetrics and Gynaecology, Preventive Medicine, Univ Autonoma de Barcelona, Bellaterra, Spain
  • d Centre for Epidemiological Studies on HIV/STI of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain, Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain, Department Paediatrics, Obstetrics and Gynaecology, Preventive Medicine, Univ Autonoma de Barcelona, Bellaterra, Spain, CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
  • e Centre for Epidemiological Studies on HIV/STI of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain, Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain, Department Paediatrics, Obstetrics and Gynaecology, Preventive Medicine, Univ Autonoma de Barcelona, Bellaterra, Spain, CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
  • f Centre for Epidemiological Studies on HIV/STI of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain, Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain, Department Paediatrics, Obstetrics and Gynaecology, Preventive Medicine, Univ Autonoma de Barcelona, Bellaterra, Spain
  • g Centre for Epidemiological Studies on HIV/STI of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain, Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain, Department Paediatrics, Obstetrics and Gynaecology, Preventive Medicine, Univ Autonoma de Barcelona, Bellaterra, Spain
  • h Centre for Epidemiological Studies on HIV/STI of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain, Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain, Department Paediatrics, Obstetrics and Gynaecology, Preventive Medicine, Univ Autonoma de Barcelona, Bellaterra, Spain, CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
  • i Centre for Epidemiological Studies on HIV/STI of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain, Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain, Department Paediatrics, Obstetrics and Gynaecology, Preventive Medicine, Univ Autonoma de Barcelona, Bellaterra, Spain, CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain

Abstract

Migrants are considered a key group at risk for HIV infection. This study describes differences between migrants and the Spanish-born population as they progress through the HIV care cascade in Catalonia, Spain. This study found that among people reached by prevention activities, migrants had a higher number of barriers to access HIV testing services than Spanish-born people, driven primarily by shared risk factors. Between 2001 and 2013, 9829 new HIV diagnoses were reported in Catalonia, the proportion of migrants increasing from 24% in 2001 to 41% in 2013. Compared with Spanish-born people, migrants had a higher proportion of women at diagnosis (24·6% vs. 16·7%), and were younger (median age of 33 vs. 37). The most frequent at-risk population was MSM (men who have sex with men) in both migrants and Spanish-born people, (40% and 43%, respectively), although there were significant differences by region of origin. People from sub-Saharan Africa had the highest proportion of late diagnosis (63·7%). Compared with the Spanish-born population, migrants on follow-up had a lower proportion of people on antiretroviral therapy (ART) (93·7% vs. 90·8%, P < 0·001) and with viral suppression (87·2% vs. 82·9%, P < 0·001). Migrants have higher number of barriers to access HIV testing services, lower retention rates and proportions on ART as compared with Spanish-born people, these differences not being uniform between migrants from different regions. Copyright © Cambridge University Press 2017.

Author Keywords

migrant Health services HIV information system Cascade Epidemiology

Index Keywords

HIV Infections race difference follow up human delayed diagnosis HIV test middle aged statistics and numerical data health service controlled study comparative study Aged ethnology Human immunodeficiency virus men who have sex with men Young Adult Humans migrant Adolescent Spaniard male Spain female risk factor Risk Factors Africa Article adult migration antiretroviral therapy Transients and Migrants acquired immune deficiency syndrome
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85014642712&doi=10.1017%2fS0950268817000437&partnerID=40&md5=ced70d1d24eaf2993e8a692768346a35
DOI: 10.1017/S0950268817000437
ISSN: 09502688
Cited by: 6
Original Language: English