The objective was to produce a cascade of care for Catalonia to gain a public health perspective on the overall quality of HIV services and allow comparison with other countries. It was constructed using the Integrated Epidemiological Surveillance System of HIV in Catalonia and data from the PISCIS Cohort.
Estimates of the number of people living with HIV in Catalonia are modelled using Spectrum Projection Package 2011 (UNAIDS/WHO). Totals for each stage in the cascade are obtained by applying to the preceding stage a proportion estimated from available surveillance and cohort data. Undiagnosed HIV was estimated from the European literature. The proportions retained in care, on ART and virally suppressed were derived from the PISCIS cohort. Programmatic data on ART consumption was used to validate estimates.
By the end of 2011 there were about 33,000 people living with HIV in Catalonia, 71% of which had been both diagnosed and linked to care. We estimate that 61% of all HIV infected persons were retained in care, 56% were on ART and 48% were virally suppressed. These figures data are comparable, although slightly lower, than that of France or the UK.
The Cascade of HIV Care in Catalonia is similar to other western European countries such as France and the UK. Direct estimates of the undiagnosed HIV population and linkage to care are desirable but the contribution of cohort data to the cascade highlights their continued importance in HIV surveillance and design of evidence-based health strategies.
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By: Campbell CN1,2,3, Ambrosioni J4, Miro JM4, Esteve A1,2,3,5, Casabona J1,2,3,5, Navarro G5,6, García I7, Ferrer E8, Force L9, Tural C10.
- 1 Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT) - ASPC , Badalona , Spain.
- 2 CIBER Epidemiologia y Salud Publica (CIBERESP) , Madrid , Spain.
- 3 Institut d'Investigació Germans Trias i Pujol (IGTP) , Badalona , Spain.
- 4 Infectious Diseases Service, Hospital Clínic - IDIBAPS , University of Barcelona , Barcelona , Spain.
- 5 Departament de Pediatria, d'Obstetricia i Ginecologia i de Medicina Preventiva i de Salut Publica , Universitat Autònoma de Barcelona , Bellaterra, Barcelona , Spain.
- 6 Corporació Sanitària i Universitària Parc Taulí , Sabadell , Spain.
- 7 Hospital General de L'Hospitalet, L'Hospitalet del Llobregat , Barcelona , Spain.
- 8 Hospital Universitari de Bellvitge, L'Hospitalet del Llobregat , Barcelona , Spain.
- 9 Hospital de Mataró , Mataró , Spain.
- 10 Hospital Universitari Germans Trias i Pujol , Badalona , Spain.
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