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Tytuł:
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Late HIV diagnosis among immigrants in Spain vs. native-born Spaniards, 2010-15.
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Autorzy:
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Gogishvili M; Center for Systems and Community Design, CUNY Graduate School of Public Health & Health Policy, New York, NY, USA.
Huang TT; Center for Systems and Community Design, CUNY Graduate School of Public Health & Health Policy, New York, NY, USA.
Costa SA; Center for Systems and Community Design, CUNY Graduate School of Public Health & Health Policy, New York, NY, USA.
Florez K; Center for Systems and Community Design, CUNY Graduate School of Public Health & Health Policy, New York, NY, USA.
Mateu-Gelabert P; Institute for Implementation Science in Population Health, CUNY, New York, NY, USA.
Valls MRA; University Hospital of Canary Islands, Santa Cruz de Tenerife, Spain.
Rivero M; Navarra Hospital Complex, Navarra, Spain.
Saumoy M; University of Bellvitge, Barcelona, Spain.
Samperiz G; University Hospital Miguel Servet, Aragon, Spain.
Cervero M; University Hospital Severo Ochoa, Madrid, Spain.
Pulido F; University Hospital 12 de Octubre (IMAS12), Complutense University of Madrid (UCM), Madrid, Spain.
Pérez JA; Infectious Diseases Department, University Hospital Ramón y Cajal (IRYCIS), Madrid, Spain.
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Corporate Authors:
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Cohort of the Spanish AIDs Research Network
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Źródło:
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European journal of public health [Eur J Public Health] 2021 Dec 01; Vol. 31 (6), pp. 1123-1128.
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Typ publikacji:
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Journal Article; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Publication: Oxford : Oxford University Press
Original Publication: Stockholm, Sweden : Almqvist & Wiksell International, c1991-
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MeSH Terms:
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Emigrants and Immigrants*
HIV Infections*/diagnosis
HIV Infections*/epidemiology
Undocumented Immigrants*
Humans ; Indigenous Peoples ; Spain/epidemiology
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Grant Information:
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Health Institute of Carlos III; Red Thematic Research Cooperative in AIDS; RD06/006 Temática de Investigación Cooperativa en Sida; National Plan R + D + I; ISCIII General Sub-direction for Evaluation and the European Regional Development Fund; RD06/006 Health Institute of Carlos III through the Red Thematic Research Cooperative in AIDS
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Entry Date(s):
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Date Created: 20210818 Date Completed: 20220202 Latest Revision: 20220202
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Update Code:
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20240104
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DOI:
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10.1093/eurpub/ckab089
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PMID:
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34405861
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Background: In 2012, the central government of Spain enacted Royal Decree-Law (RDL) 16/2012 and Royal Decree (RD) 1192/2012, which abolished universal healthcare coverage, thus limiting access to care for undocumented immigrants. Free health care was also no longer granted to anyone who has never been employed. In this context, this study investigated the prevalence of late HIV diagnoses (LHDs) among immigrants living in Spain vs. native-born Spaniards.
Methods: Data (n = 5943) from the 2010 to 2015 Cohort of the Spanish AIDs Research Network were used, including HIV-positive and antiretroviral therapy (ART)-naïve patients throughout Spain. Multivariate logistic models were fitted to compare the prevalence of LHD among the groups, adjusting for covariates.
Results: The prevalence of LHD in the total sample was 39.5%. Compared with native-born Spaniards (n = 4445), immigrants (n = 1488) were more likely to have LHD (37.4% vs. 45.7%, respectively; P < 0.001). Multivariate analysis showed that the prevalence ratio of LHD among immigrants vs. native-born Spaniards was 1.15 [95% confidence interval (CI), 1.02-1.28], after adjusting for covariates. This disparity widened from 2010 to 2011 (APR = 1.14, 95% CI, 1.02-1.29) to 2012-15 (APR = 1.28, 95% CI, 1.17-1.39), although the change was not statistically significant.
Conclusions: Immigrants in Spain had a higher risk of LHD compared with native-born counterparts. LHD is an important healthcare marker due to the positive benefits of early HIV diagnosis, including prevention, improvements in health outcomes and decreases in overall cost of treatment. More research is needed on the causes of the disparity and potential social and policy interventions to reduce the prevalence of LHD among immigrants.
(© The Author(s) 2021. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.)
