X-ray of HIV-AIDS in Spain: the number of cases is falling, but transmission among these people is a concern
December 1, World AIDS Day, is a good time to take stock of the prevention, transmission, diagnosis and treatment of the human immunodeficiency virus (HIV). In Spain, as in other neighboring countries, after more than two decades of effective antiretroviral treatment, reducing the incidence of AIDS was very important. However, there is still a long way to go to eradicate this infection, and above all, there are groups of people for whom transmission has not decreased that much.
Report Epidemiological surveillance of HIV and AIDS in Spain, 2023.published on November 20 and prepared by the National Epidemiological Center of the Carlos III Institute of Health, shows a downward trend in the number of new HIV diagnoses in Spain between 2013 and 2023. However, he also highlights the persistence of late diagnosis, especially in women and the elderly..
New diagnoses and forms of transmission
According to a new report, In 2023, there were 3,196 new HIV diagnoses.. According to the paper’s authors, the overall rate of new HIV diagnoses in Spain is currently at a level similar to other Western European countries, although higher than the European Union average.
The predominant route of transmission was sexual (80.7%), with higher incidence among men who have sex with men (MSM) (55%). Heterosexual relationships accounted for 25.7% of cases, and injection drug use accounted for only 1.7%. By age, 33.5% of new diagnoses occur in the group from 25 to 34 years old; 11.5% were aged 15 to 24 years and 18.3% were aged 50 years or older. The highest age indicator was observed in the group from 30 to 34 years.
People most affected by late diagnosis
One of the most worrying aspects is late diagnosis, which occurred in almost half (48.7%) of people who tested positive in HIV tests in 2023. This means that the infection is already well advanced at the time of diagnosis.
Late detection increases with age. Bye among persons under 25 years of age this occurred in 33.4% of casesFor people over 50 years of age, this figure rises to 61.5%.
Regarding the form of transmission, the heterosexual route has the highest rates of late diagnosis.which is 57.8% for men and 53.5% for women. 42.1% of men who have sex with men (MSM) receive a late diagnosis.
Groups that should focus on prevention and diagnosis
“Unprotected sex between men ranks highest as a likely transmission mechanism in the global data set,” the report authors note. So they add: “MSM group – priority of prevention programs” In fact, the rate of reduction in viral transmission varied among this group. Although the overall trend in new HIV diagnoses is decreasing between 2013 and 2023, there are differences by mode of transmission. Thus, among both injecting drug users and heterosexuals, the decline extends throughout the period, “while among MSM the trend has been observed since 2017, with some differences depending on the place of origin.”
Another group to pay attention to because of their particular vulnerability is people from other countries, which accounted for almost half of new diagnoses HIV in 2023. Its distinctive characteristics “make it necessary to diversify prevention programs to adapt them to the needs of this group, which is socially and culturally very heterogeneous and particularly vulnerable.”