AEGiS-14IAC: HIV infection in Madrid 1984 -- 2001: growing impact of immigrants.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

HIV infection in Madrid 1984 -- 2001: growing impact of immigrants.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. C10702)

Barros C, mez J, Sanz J, Gaspar G, Castilla V, Alberdi JC
Hospital Mostoles, Mostoles, Spain

BACKGROUND: persons not born in Spain are a growing population group. They are coming from high incidence areas of HIV infection where dominate heterosexual transmission. Their impact in our local HIV epidemic is analyzed.

METHODS: Cohort study of all patients diagnosed as having HIV infection at the 5 hospitals of Madrid South East Metropolitan Area, providing care to a population of 1300000 inhabitants. Immigrants were compared with Spain born HIV infected patients by demographic, clinical, and care management variables. x2 test, t-test, Kaplan-Meier and log rank test were used.

RESULTS: At the end of December 2001, 5958 patients were included in the cohort. Of them 188 (3.2%) were immigrants, more than a half coming from Africa. A positive temporal trend was detected, ranging from 1.1% before 1990 to 22.6% in 2001(p<0.000). Immigrants had a male-female ratio of 1.1 vs. a ratio in native infected people of 2.93. Immigrants were mainly infected (59%) by heterosexual transmission. Natives had IDU 74.1% as a main mode of transmission. No differences were detected by CDC group at the moment of diagnosis. The differences in the mean of drugs prescribed for treatment, mean visits to the clinic and mean number of persons lost to follow up during treatment were not statistically significant. The difference in the mean CD4 at the moment of diagnosis was statistically significant (320.8 in natives vs. 372.6 in immigrants).These differences disappear after treatment. Both groups had the same CD4 number in their last visit (444 vs. 425.6 p=. 551).Median survival time was greater in natives than in immigrants 14.10 vs. 8.42 but this difference did not reach statistical significance.

CONCLUSIONS: Africans experience high rates of HIV infection by heterosexual transmission. Immigrants coming to our region reflect the same pattern. It represents a growing public health problem. Language and cultural barriers do not seem to discourage their access to health care services.

Keywords: AEGIS, HIV Infections, Emigration and Immigration, Heterosexuality, Incidence, Cohort Studies, HIV Seropositivity, Disease Outbreaks, Spain, Africa, Female, Male, Human

020707
C10702