Prevalence of HIV Infection in Patients Seen at Specialized Diagnosis Centers in 9 Cities in Spain From 1992 to 2001

OBJECTIVE: To describe the prevalence of HIV infection in persons tested between 1992 and 2001. DESIGN: Descriptive, cross-sectional epidemiological study. SETTING: 10 ambulatory centers specialized in diagnosing HIV, located in 9 cities in Spain. PARTICIPANTS: 53,183 persons older than 12 years, tested for the first time for HIV. MAIN MEASURES: Number of persons tested per year, number of persons diagnosed as seropositive for HIV according to sex, age group and category of exposure. RESULTS: The number of persons tested increased from 4401 in 1992 to 6407 in 2001. Approximately half reported heterosexual risk exposure/exposure through high-risk heterosexual behaviors, excluding prostitution. Intravenous drug users (IVDU) increased from 15.3% in 1992-1993 to 1.4% in 2000-2001, and women prostitutes/female sex workers increased from 6.7% to 25.1%. A total of 2898 persons were diagnosed as having HIV infection; 78% of them were men. The number of diagnoses decreased from a high of 1058 in 1992-1993 to 304 in 2000-2001, and this trend was seen for all categories of exposure except female prostitutes and men with heterosexual risk factors. The prevalence decreased from 14% in 1992 to 2% in 2001. There were decreases in all categories of exposure, especially during the first years of the study, with a tendency to level off. In 2001 the prevalence figures were 23.8% for IVDU, 7.9% for homosexual men and women, 0.8% for female sex workers and 1% for other heterosexual men and women. CONCLUSIONS: The specialized diagnostic centers play an important role in diagnosing HIV, and this service complements primary care services. Greater efforts are needed in the prevention of HIV infection.