48.7% of new HIV diagnoses in Spain come late

Treatment for HIV has improved since the first cases were diagnosed 40 years ago. However, the virus continues to be a public health problem of “first magnitude in Spain,” according to experts. The country still sees more than 3,000 new patients diagnosed each year – 3,196 cases in 2023, according to a surveillance report released this week by the Ministry of Health. Of these, 48.7% are diagnosed late, when the infection has already spread significantly, especially among people over 50 years of age (61.5%) and in heterosexual transmission, where it affects 57.8% of men and 53.5% of women. Thus, making a late diagnosis delays the initiation of treatment and the possibility of achieving a so-called undetectable viral load, a situation in which the virus cannot be transmitted. The rate of new HIV diagnoses in Spain is similar to that of other Western European countries, although higher than the European Union average. There are an estimated 130,000 to 160,000 people living with the virus in Spain.

These data were presented at the XV National Congress of GeSIDA, the main scientific meeting on HIV held in Spain and one of the most relevant on the European continent, from the AIDS Research Group of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC). calls on health administrations to take more ambitious measures to promote more effective prevention and early diagnosis of new cases, and to avoid any type of stigma or discrimination that becomes an obstacle to better control of the virus. “The great Achilles heel of the fight against HIV in Spain continues to be prevention and early diagnosis. Given this reality, we call on GeSIDA to expand and generalize the effectiveness of the test as a more effective measure,” emphasized GeSIDA President Dr. Rosario Palacios, who is also responsible for the Infectious Diseases Unit of the Virgen de la Victoria. Hospital in Malaga.

This SEIMC research group also advocates the need to raise awareness of the importance of prevention and early diagnosis among the general population and among those health workers who do not work directly with people with HIV, such as primary health care professionals, with whom GeSIDA already works with initiatives such as the “Document on collaborative management of HIV patients between primary and hospital care”, prepared jointly with the Spanish Society of Family and Community Medicine. (SEMFIC).

GeSIDA representatives believe that progress in the fight against HIV has been significant, but not sufficient. The Association proposes measures, collected in a roadmap, based on the following strategies: facilitating access to PrEP, overcoming existing medical and sociocultural barriers; make a diagnosis and begin treatment as early as possible; achieve retention and continuity of care (especially for more vulnerable people such as migrants), avoiding interruptions in treatment (which are associated with high numbers of deaths and AIDS cases), combat the recurrence of transmitted infections (STIs) at increasingly younger ages and risky sexual practices (strengthening information and epidemiological surveillance) and improving the diagnosis and treatment of coinfections.

Specialty “Infectious diseases”

GeSIDA also considers it “essential” to train specialists in this field and notes that Spain is the only country in Europe that does not have a medical specialty in infectious diseases. In addition, he adds that in the next five years, a third of the health workers who care for people living with HIV (more than 200) are expected to retire, without ensuring a generational change and the arrival of new specialists in the fight against this virus.

As part of the opening of the XV National Congress of GeSIDA, the Minister of Health Monica García announced in a video message her intention to prioritize the creation of the specialty “Infectious Diseases” at the next meeting of the Working Group on Specialties, which will be dedicated in December this year.

SEIMC President Dr. Federico Garcia recalled that the achievement of this specialty is “a historical statement with deep scientific support, since the care of a specialist properly trained in the treatment of severe and complicated infections has been proven to reduce the mortality rate of patients. We cannot afford to continue to be the only European country without specialization,” emphasizes the SEIMC chief representative.

National Congress of GeSIDA

All these proposals and analysis of the HIV situation in Spain were made from Zaragoza, the city where the XV National Congress of GeSIDA took place, which brings together more than 600 national and international experts to review the main achievements and contradictions in the fight against HIV. HIV-AIDS. Among the topics discussed these days in the capital of Aragon, some represent “the future of the fight against HIV infection,” as explained by the presidents of the meeting, doctors Antonio Antela and Maria Salgado.

These topics include new treatment options (especially those called “long-acting” ones that can be used weekly to annually), new strategies aimed at curing the virus (immunotherapy, gene therapy, etc.), or the use of new technologies to better understand how the virus works and therefore be able to develop strategies to combat it.