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:
- 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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