Characteristics and outcome of HIV infection in gypsies in the Spanish VACH Cohort.
OBJECTIVE
To study the characteristics of HIV infection in the gypsy (Roma) population in Spain, as compared with those of the Caucasian, non-gypsy majority.


METHODS
Cross-sectional, historical cohort study from the Spanish VACH Cohort.


METHODS
Patients attending VACH clinics between 1 June 2004 and 30 November 2004 were classified according to their racial and ethnic origin as "gypsies", Caucasian non-gypsy Spanish natives (CNGN), and "other" (the last being excluded from this study). Their sociodemographic and clinico-epidemiological characteristics were compared, as well as the Kaplan-Meier curves of time to AIDS, or death, or disease progression (either of the 2 outcomes).


RESULTS
4819 (48%) of 10,032 cases included in the VACH database were eligible: 210 (4.2%) were gypsies and 4252 (84.8%) were CNGN. Differences were observed in age, household, academic, inmate, marital, and employment history. Injecting drug use had been the most frequent mechanism of transmission in both groups, but to a greater extent among gypsies (72% versus 50%; P<0.000). Sex distribution, CD4 cell counts, and viral loads at the first visit were similar in the 2 groups, as was the percentage of patients with previous AIDS, percentage receiving antiretrovirals, and percentage subsequently starting antiretroviral therapy. Up to 1 April 2005, 416 new AIDS cases and 85 deaths were recorded. The percentage of these outcomes did not differ between groups, but log-rank test showed a shorter time to AIDS and disease progression among gypsies.


CONCLUSIONS
The sociodemographic characteristics of gypsies, the largest minority in the VACH Cohort, show differences relative to those of CNGN. HIV-related outcomes suggest that gypsies have a poorer prognosis.
Hospital de Sierrallana, Torrelavega, Cantabria, Spain. rteira@hsll.scsalud.es
Ramón
R
Teira
Ignacio
I
Suárez-Lozano
Fernando
F
Lozano
Pompeyo
P
Viciana
Pere
P
Domingo
Pepa
P
Galindo
Paloma
P
Geijo
Alberto
A
Terrón
Juan
J
González
Jaime
J
Cosín
Esteban
E
Ribera
Bernardino
B
Roca
María L
ML
García-Alcalde
Trinitario
T
Sánchez
Agustín
A
Muñoz-Sánchez
Antonio
A
Vergara
José
J
López-Aldeguer
Enric
E
Pedrol
Francesc
F
Vidal
Myriam
M
Garrido
Juan M
JM
Santamaría
D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D008297:Male; D006178:Romani People; D013030:Spain