HIV infections are not decreasing, and a third of cases are diagnosed late.

BarcelonaA third of HIV diagnoses in Catalonia are made late, when patients have already suffered an opportunistic infection or when their immune system has already begun to deteriorate. The same is true for half of all diagnoses in Europe, as the World Health Organization (WHO) warned this week. These delays in diagnosis are precisely one of the main reasons experts cite for why diagnoses have not fallen below 3,000 new cases annually over the last fifteen years. Dr. Joaquín Burgos, from the Infectious Diseases Department at Vall d'Hebron Hospital, explains in an interview with ACN on the occasion of World AIDS Day, commemorated every year on December 1st, that the delay in diagnosis is one of the "main problems" that persists with the HIV virus. On the one hand, because these people have had the infection for years without knowing it and have been able to transmit the disease. Even if they haven't had any opportunistic infections, Burgos adds, and even if patients begin treatment after diagnosis and their condition improves, the time they have spent with HIV "has an impact on future comorbidities," meaning additional chronic health problems. On the other hand, the doctor adds, the prognosis for patients has changed radically in the last forty years: it has gone from being a death sentence for many people to being able to have an undetectable viral load and a quality of life equivalent to the rest of the population. Meanwhile, Burgos points out, challenges remain, such as breaking the stigma, achieving greater social awareness, and ensuring that the healthcare system doesn't miss opportunities for diagnostic testing. "There are what are called missed opportunities, when a person has been through the healthcare system with a condition associated with HIV infection, but hasn't been offered a test," he explains.

To improve HIV detection, the doctor believes it is necessary to increase public awareness, as society has "little perception of risk," especially among heterosexuals and older people. "Anyone can contract HIV, and often we never get tested," he warns.

Stuck on the threshold of 3,000 cases

Over the past fifteen years, the number of diagnoses across the country has not fallen below 3,000. Last year, 3,340 cases were reported, slightly fewer than in 2023, when there were 3,350. According to the latest epidemiological surveillance report on HIV and AIDS in Spain from the Ministry of Health, there were 3,337 diagnoses in 2022 and 3,192 in 2021. These figures are lower than those of, for example, 2013 (4,471) and 2014 (4,561), but the number has not dropped below the 3,000 mark since 2009, when there were 2,246.

The president of the AIDS Study Group of the Spanish Society of Infectious Diseases (GeSIDA), María Velasco, points first and foremost to the delays in diagnosis when explaining the reasons for these figures. In statements to EFE, she notes that the fact that diagnoses are late means that people with the infection, without knowing they have it, transmit it.

Velasco also points out that, despite the need for sex education in schools, the risks of sexual transmission affect "many groups, and perhaps more emphasis needs to be placed on information and training" in other age groups. She adds that migrants currently account for more than half of new diagnoses: "If they don't have good access to preventive measures, here we have another factor that continues to fuel these 3,000 new diagnoses annually."