Mónica Ruiz

Never tested for HIV in Latin-American migrants and Spaniards: prevalence and perceived barriers

Increasing the uptake of HIV testing and decreasing the number of undiagnosed people is a priority for HIV prevention. Understanding the barriers that hinder people from testing is vital, particularly when working with especially vulnerable populations like migrants. Most data available on migrants are based on African migrants in the UK, while barriers to HIV testing in Latin‐American migrants living in Europe remain unexplored. Still, they account for a quarter of new diagnosis in Spain and suffer higher rates of delayed diagnosis.

Tendencia temporal de la incidencia de cáncer en Navarra y Zaragoza

Resumen Objetivo Conocer los cambios que se producen en los patrones de incidencia y mortalidad por cancer con el paso del tiempo es un elemento basico para su control. En este trabajo se presentan los resultados sobre la evolucion temporal de la incidencia de los tumores mas importantes en Navarra y Zaragoza. Metodos Se ha utilizado un modelo log-lineal para evaluar el efecto de la edad, el periodo de diagnostico y la cohorte de nacimiento en las tendencias de la incidencia de cancer empleando los datos de los registros de Navarra y Zaragoza. Los resultados se muestran en forma grafica para los diferentes tumores, en cada registro y sexo. Resultados En hombres, destaca el fuerte aumento de la incidencia en cancer de pulmon (5% anual), prostata (> 2% anual) y linfomas no hodgkinianos. En mujeres, los incrementos mas altos se han producido en linfomas no hodgkinianos con aumentos superiores al 7% anual y en el cancer de ovario (4% anual). El cancer de mama en mujeres ha aumentado en ambas provincias (Navarra 3,5% y Zaragoza 0,9%), siendo una parte del incremento en Navarra derivado de una mayor deteccion de casos. En ambos registros y en los dos sexos se han producido incrementos de la incidencia superiores al 3% anual en cancer colorrectal, de vejiga y de rinon. Para la mayor parte de los tumores el riesgo de padecer un cancer se incrementa en las sucesivas generaciones, con la excepcion del cancer de estomago y del cancer de higado. Conclusiones El importante incremento de la incidencia de cancer pone de manifiesto la insuficiencia de las politicas de prevencion primaria, la importancia de disponer de datos de incidencia en series prolongadas en el tiempo y la necesidad de aumentar la cobertura poblacional de los registros de cancer en Espana.

La oferta de la prueba rápida del VIH en la calle dentro del ámbito universitario: ¿una estrategia prioritaria?

OBJECTIVE To evaluate an HIV testing program in the university environment by analyzing the prevalence of infection, risk behaviors and history of sexually transmitted infections and by performing HIV tests. METHODS During October-November of 2008 and November-December of 2009, 1668 persons received rapid HIV testing in a mobile unit located in university campuses in the cities of Madrid, Málaga and Salamanca (Spain). While waiting for the test results, participants completed a brief questionnaire. RESULTS A total of 15.7% were men who had sex with men (MSM), 28.6% were exclusively heterosexual men (HTX), and 55.7% were women. Nearly three-quarters (73.3%) were under 25 years of age, 8.5% were born abroad and only 4% had no secondary education. Fifty-one percent of HTX, 42% of women and 6.3% of MSM had casual sexual partners in the past 12 months without always using a condom. This behavior was also reported by 41.5% of MSM with same sex partners. A sexually transmitted infection had previously been diagnosed in 24.7% of MSMs, 14.7% of women and 5.6% of HTX. Four positive results were found, all in MSM who had been tested in the previous 2 years. The prevalence was 1.6% (95% CI: 0.43-3.95) within this group, and 0.2% overall (95% CI: 0.07-0.62). CONCLUSIONS Despite the high frequency of risk behaviors, the low prevalence of HIV infection and the history of HIV testing suggest that university campuses are not a priority location to develop these programs, which would achieve greater impact and efficiency in more vulnerable populations.

Low HIV testing uptake following diagnosis of a sexually transmitted infection in Spain: implications for the implementation of efficient strategies to reduce the undiagnosed HIV epidemic

ABSTRACT Sexually transmitted infections (STIs) are recognized as one of the conditions in which HIV testing is most clearly indicated. We analyse whether people diagnosed with an STI are being tested for HIV according to the experience of participants in an outreach rapid testing programme in Spain. Between 2008 and 2010, 6293 individuals underwent rapid testing and completed a self-administered questionnaire. We calculated the percentage of individuals that were diagnosed with an STI in the last 5 years and identified the setting where the last episode occurred. We then determined the percentage not receiving an HIV test after the last STI diagnosis and estimated the associated factors. Overall, 17.3% (N = 959) of participants reported an STI diagnosis in the last 5 years, of which 81.5% occurred in general medical settings. Sixty-one percent reported not undergoing HIV testing after their last STI diagnosis, 2.2% of whom reported they had refused the test. Not receiving an HIV test after the last STI diagnosis was independently associated with not being a man who has sex with men (MSM), having had fewer sexual partners, being diagnosed in general medical settings and having received a diagnosis other than syphilis. An unacceptably large percentage of people diagnosed with STI are not being tested for HIV because healthcare providers frequently fail to offer the test. Offering routine HIV testing at general medical settings, regardless of the type of STI diagnosed and population group, should be a high priority and is probably a more efficient strategy than universal screening in general healthcare settings.

Street outreach rapid HIV testing in university settings: a priority strategy?

OBJECTIVE To evaluate an HIV testing program in the university environment by analyzing the prevalence of infection, risk behaviors and history of sexually transmitted infections and by performing HIV tests. METHODS During October-November of 2008 and November-December of 2009, 1668 persons received rapid HIV testing in a mobile unit located in university campuses in the cities of Madrid, Málaga and Salamanca (Spain). While waiting for the test results, participants completed a brief questionnaire. RESULTS A total of 15.7% were men who had sex with men (MSM), 28.6% were exclusively heterosexual men (HTX), and 55.7% were women. Nearly three-quarters (73.3%) were under 25 years of age, 8.5% were born abroad and only 4% had no secondary education. Fifty-one percent of HTX, 42% of women and 6.3% of MSM had casual sexual partners in the past 12 months without always using a condom. This behavior was also reported by 41.5% of MSM with same sex partners. A sexually transmitted infection had previously been diagnosed in 24.7% of MSMs, 14.7% of women and 5.6% of HTX. Four positive results were found, all in MSM who had been tested in the previous 2 years. The prevalence was 1.6% (95% CI: 0.43-3.95) within this group, and 0.2% overall (95% CI: 0.07-0.62). CONCLUSIONS Despite the high frequency of risk behaviors, the low prevalence of HIV infection and the history of HIV testing suggest that university campuses are not a priority location to develop these programs, which would achieve greater impact and efficiency in more vulnerable populations.

La oferta de la prueba rápida del VIH en la calle dentro del ámbito universitario, ¿una estrategia prioritaria?

OBJECTIVE To evaluate an HIV testing program in the university environment by analyzing the prevalence of infection, risk behaviors and history of sexually transmitted infections and by performing HIV tests. METHODS During October-November of 2008 and November-December of 2009, 1668 persons received rapid HIV testing in a mobile unit located in university campuses in the cities of Madrid, Málaga and Salamanca (Spain). While waiting for the test results, participants completed a brief questionnaire. RESULTS A total of 15.7% were men who had sex with men (MSM), 28.6% were exclusively heterosexual men (HTX), and 55.7% were women. Nearly three-quarters (73.3%) were under 25 years of age, 8.5% were born abroad and only 4% had no secondary education. Fifty-one percent of HTX, 42% of women and 6.3% of MSM had casual sexual partners in the past 12 months without always using a condom. This behavior was also reported by 41.5% of MSM with same sex partners. A sexually transmitted infection had previously been diagnosed in 24.7% of MSMs, 14.7% of women and 5.6% of HTX. Four positive results were found, all in MSM who had been tested in the previous 2 years. The prevalence was 1.6% (95% CI: 0.43-3.95) within this group, and 0.2% overall (95% CI: 0.07-0.62). CONCLUSIONS Despite the high frequency of risk behaviors, the low prevalence of HIV infection and the history of HIV testing suggest that university campuses are not a priority location to develop these programs, which would achieve greater impact and efficiency in more vulnerable populations.