title: A low-cost, sustainable, second generation system for surveillance of people living with HIV in Spain: 10-year trends in behavioural and clinical indicators, 2002 to 2011.
abstract: A second-generation surveillance system of people infected with human immunodeficiency virus (HIV) has been implemented in Spain. Behavioural and clinical data were collected between 2002 and 2011 through an annual one-day, cross-sectional survey in public hospitals, including all in- and outpatients receiving HIVrelated care on the survey day. Mean age increased over time (from 38.7 years in 2002 to 43.8 years in 2011) and 68.4% of the 7,205 subjects were male. The proportion of migrants increased from 6.1% to 15.9%, while people who inject or used to inject drugs (PWID and Ex-PWID) decreased and men who have sex with men (MSM) and heterosexuals increased. Unprotected intercourse at last sex increased among MSM and PWID/Ex-PWID. Patients receiving antiretroviral treatment increased significantly from 76.0% to 88.2% as did those with CD4 T-cell counts ≥350 (from 48.2% to 66.9%) and viral copies <200 (from 47.0% to 85.2%). HIV-infected people with hepatitis C virus RNA decreased from 36.0% in 2004 to 29.9% in 2011, while those with HBsAg remained stable at around 4.4%. Implementation of a low-cost, sustainable system for second-generation surveillance in people living with HIV is feasible. In Spain, the information obtained has helped to define and refine public health policy and document treatment effectiveness.
authors.affiliation: Plan Nacional sobre el Sida. S.G. de Promocion de la Salud y Epidemiologia. Ministerio de Sanidad, Servicios Sociales e Igualdad (National Plan on AIDS. Subdirectorate of Health Promotion and Epidemiology. Ministry of Health, Social Services and Equality), Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Diez
authors.forename: A
authors.initials: A
authors.lastname: Diaz
authors.forename: C
authors.initials: C
authors.lastname: Garriga
authors.forename: M
authors.initials: M
authors.lastname: Pons
authors.forename: A
authors.initials: A
authors.lastname: Ten
authors.forename: H
authors.initials: H
authors.lastname: Marcos
authors.forename: G
authors.initials: G
authors.lastname: Gutierrez
authors.forename: S
authors.initials: S
authors.lastname: Moreno
authors.forename: J
authors.initials: J
authors.lastname: Gonzalez-Garcia
authors.forename: Am
authors.initials: A
authors.lastname: Barrios
authors.forename: S
authors.initials: S
authors.lastname: Arponen
authors.forename: Mt
authors.initials: M
authors.lastname: Garcia
authors.forename: Mc
authors.initials: M
authors.lastname: Royo
authors.forename: J
authors.initials: J
authors.lastname: Toledo
authors.forename: G
authors.initials: G
authors.lastname: Gonzalez
authors.forename: R
authors.initials: R
authors.lastname: Aranguren
authors.forename: A
authors.initials: A
authors.lastname: Izquierdo
authors.forename: Lj
authors.initials: Lj
authors.lastname: Viloria
authors.forename: L
authors.initials: L
authors.lastname: Elizalde
authors.forename: E
authors.initials: E
authors.lastname: Martinez
authors.forename: D
authors.initials: D
authors.lastname: Castrillejo
authors.forename: I
authors.initials: I
authors.lastname: Lopez
authors.forename: C
authors.initials: C
authors.lastname: Redondo
authors.forename: A
authors.initials: A
authors.lastname: Cano
authors.forename: C
authors.initials: C
authors.lastname: The Hospital Survey Study Group
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission; D015438:Health Behavior; D006306:Health Surveys; D006526:Hepatitis C / Q000453:epidemiology* / Q000635:transmission; D020010:Heterosexuality / Q000706:statistics & numerical data; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006779:Hospitals, Public; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*
chemical_list: D044966:Anti-Retroviral Agents