GeSIDA calls for more ambitious action to improve HIV control

On the occasion of 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 SEIMC (Spanish Society of Infectious Diseases and Clinical Microbiology) Health Administrations need to take more ambitious measures to promote more effective prevention and early diagnosis of new cases, avoiding any type of stigma or discrimination that becomes an obstacle to better control. virus.

HIV continues to be a major public health problem in Spain. Despite significant improvements in the treatment of the virus since the first cases were reported 40 years ago, the country is still diagnosing an average of more than 3,000 new patients per year (3,196 cases in 2023 according to the Epidemiological Surveillance Report published by the Ministry of Health) , of which 48.7% are diagnosed late, when the infection has already progressed significantly, especially among people over 50 years of age. (61.5%) and during heterosexual transmission, in which 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 great Achilles heel of the fight against HIV in Spain continues to be prevention and early diagnosis. Given this reality, we at GeSIDA call for the expansion and generalization of the effectiveness of the test as a more effective measure,” emphasizes the President of GeSIDA, Dr. Rosario Palacios, who is also in charge of the Infectious Diseases Unit of the Virgen de la Victoria. Hospital in Malaga. 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.

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 colleagues in primary care, with whom GeSIDA already collaborates with such initiatives such as the “Document on collaborative management of HIV patients between primary and hospital care”, prepared jointly with SEMFYC (Spanish Society of Family Medicine). and Community).

Given that progress in the fight against HIV has been significant but insufficient, GeSIDA proposes more ambitious measures included in the roadmap, based on the following fundamental 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.

Infectious disease specialist required

To achieve an ambitious response to the challenge that HIV continues to pose, it is also considered necessary to have professionals trained in this field. Spain is the only country in Europe that does not have a medical specialty in Infectious Diseases.

About a third of health workers caring for people living with HIV (more than 200) are expected to retire in the next five years, causing deep concern among the group as they are not immune to generational change and the arrival of new experts to combat it a virus that poses a problem not only from the point of view of prevention and early diagnosis, but also the care of elderly patients.

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 recalls that the achievement of this specialty is “a historical statement with deep scientific support, since it has been demonstrated that the care of a specialist properly trained in the treatment of severe and complicated infections reduces 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, the main scientific forum on HIV in Spain

All these proposals and analyzes of the HIV situation in Spain were carried out from Zaragoza, the city where the XV National Congress of GeSIDA is taking place from last Sunday until next Wednesday, which brings together more than 600 national and international experts to review the main achievements and contradictions in the fight against 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.

Among these topics are new treatment options (especially those called ‘long lasting’which can be administered 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 control strategies him.