title: Differences between migrants and Spanish-born population through the HIV care cascade, Catalonia: an analysis using multiple data sources.
abstract: Migrants are considered a key group at risk for HIV infection. This study describes differences between migrants and the Spanish-born population as they progress through the HIV care cascade in Catalonia, Spain. This study found that among people reached by prevention activities, migrants had a higher number of barriers to access HIV testing services than Spanish-born people, driven primarily by shared risk factors. Between 2001 and 2013, 9829 new HIV diagnoses were reported in Catalonia, the proportion of migrants increasing from 24% in 2001 to 41% in 2013. Compared with Spanish-born people, migrants had a higher proportion of women at diagnosis (24·6% vs. 16·7%), and were younger (median age of 33 vs. 37). The most frequent at-risk population was MSM (men who have sex with men) in both migrants and Spanish-born people, (40% and 43%, respectively), although there were significant differences by region of origin. People from sub-Saharan Africa had the highest proportion of late diagnosis (63·7%). Compared with the Spanish-born population, migrants on follow-up had a lower proportion of people on antiretroviral therapy (ART) (93·7% vs. 90·8%, P < 0·001) and with viral suppression (87·2% vs. 82·9%, P < 0·001). Migrants have higher number of barriers to access HIV testing services, lower retention rates and proportions on ART as compared with Spanish-born people, these differences not being uniform between migrants from different regions.
authors.affiliation: Centre for Epidemiological Studies on HIV/STI of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC),Generalitat de Catalunya,Badalona,Spain.
authors.forename: J
authors.initials: J
authors.lastname: Reyes-Urueña
authors.affiliation: Centre for Epidemiological Studies on HIV/STI of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC),Generalitat de Catalunya,Badalona,Spain.
authors.forename: C
authors.initials: C
authors.lastname: Campbell
authors.affiliation: Centre for Epidemiological Studies on HIV/STI of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC),Generalitat de Catalunya,Badalona,Spain.
authors.forename: C
authors.initials: C
authors.lastname: Hernando
authors.affiliation: Centre for Epidemiological Studies on HIV/STI of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC),Generalitat de Catalunya,Badalona,Spain.
authors.forename: N
authors.initials: N
authors.lastname: Vives
authors.affiliation: Centre for Epidemiological Studies on HIV/STI of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC),Generalitat de Catalunya,Badalona,Spain.
authors.forename: C
authors.initials: C
authors.lastname: Folch
authors.affiliation: Centre for Epidemiological Studies on HIV/STI of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC),Generalitat de Catalunya,Badalona,Spain.
authors.forename: L
authors.initials: L
authors.lastname: Ferrer
authors.affiliation: Centre for Epidemiological Studies on HIV/STI of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC),Generalitat de Catalunya,Badalona,Spain.
authors.forename: L
authors.initials: L
authors.lastname: Fernández-López
authors.affiliation: Centre for Epidemiological Studies on HIV/STI of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC),Generalitat de Catalunya,Badalona,Spain.
authors.forename: A
authors.initials: A
authors.lastname: Esteve
authors.affiliation: Centre for Epidemiological Studies on HIV/STI of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC),Generalitat de Catalunya,Badalona,Spain.
authors.forename: J
authors.initials: J
authors.lastname: Casabona
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D057210:Delayed Diagnosis; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000208:ethnology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D014171:Transients and Migrants / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Cascade; HIV; epidemiology; health services; information system; migrant