title: The continuum of HIV care in Catalonia.
abstract: 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.
authors.affiliation: a Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT) - ASPC, Badalona, Spain.|b CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.|c Institut d'Investigació Germans Trias i Pujol (IGTP), Badalona, Spain.
authors.forename: Colin N J
authors.initials: CN
authors.lastname: Campbell
authors.affiliation: d Infectious Diseases Service, Hospital Clínic - IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Ambrosioni
authors.affiliation: d Infectious Diseases Service, Hospital Clínic - IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Miro
authors.affiliation: a Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT) - ASPC, Badalona, Spain.|b CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.|c Institut d'Investigació Germans Trias i Pujol (IGTP), Badalona, Spain.|e Departament de Pediatria, d'Obstetricia i Ginecologia i de Medicina Preventiva i de Salut Publica, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain.
authors.forename: Anna
authors.initials: A
authors.lastname: Esteve
authors.affiliation: a Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT) - ASPC, Badalona, Spain.|b CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.|c Institut d'Investigació Germans Trias i Pujol (IGTP), Badalona, Spain.|e Departament de Pediatria, d'Obstetricia i Ginecologia i de Medicina Preventiva i de Salut Publica, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Casabona
authors.affiliation: e Departament de Pediatria, d'Obstetricia i Ginecologia i de Medicina Preventiva i de Salut Publica, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain.|f Corporació Sanitària i Universitària Parc Taulí, Sabadell, Spain.
authors.forename: Gemma
authors.initials: G
authors.lastname: Navarro
authors.affiliation: g Hospital General de L'Hospitalet, L'Hospitalet del Llobregat , Barcelona, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: García
authors.affiliation: h Hospital Universitari de Bellvitge, L'Hospitalet del Llobregat , Barcelona, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Ferrer
authors.affiliation: i Hospital de Mataró, Mataró, Spain.
authors.forename: Lluis
authors.initials: L
authors.lastname: Force
authors.affiliation: j Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Tural
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D003266:Continuity of Patient Care; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011159:Population Surveillance; D013030:Spain; D016903:Drug Monitoring
chemical_list: D019380:Anti-HIV Agents
keywords: ART; Catalonia; HIV; Spain; cascade