RESUMO
This paper analyses late presentation (LP) of HIV infection, and its determinants, among men who have sex with men (MSM) in Spain, newly diagnosed with HIV (2003-2011) in 15 sexually transmitted infection/HIV counselling and testing clinics. LP was defined as <350 CD4 cells/µL or AIDS. In total, 3,081 MSM were included (2,499 having CD4/AIDS); overall LP was 25.3%. LP was higher in men older than 34 years, those not previously HIV-tested (adjusted odds ratio (aOR):3.1; 95% confidence intervals (CI):2.3-4.2) , and those tested > 12 months before diagnosis (12-24 months (aOR:1.4; 95% CI:1.0-2.0); > 24 months (aOR:2.2; 95% CI:1.7-3.0)). LP was less likely in MSM reporting a known HIV-infected partner as infection source or symptoms compatible with acute retroviral syndrome. 'Region of birth' interacted with 'educational level' and 'steady partner as infection source': only African and Latin-American MSM with low educational level were more likely to present late; Latin-American men attributing their infection to steady partner, but no other MSM, had LP more frequently. In Spain, HIV testing among MSM should be promoted, especially those > 34 years old and migrants with low educational level. The current recommendation that MSM be tested at least once a year is appropriate.
Assuntos
Diagnóstico Tardio , Infecções por HIV/diagnóstico , Homossexualidade Masculina , Adulto , África/etnologia , Idade de Início , Centros Comunitários de Saúde , Aconselhamento , Escolaridade , Infecções por HIV/etnologia , Infecções por HIV/transmissão , Humanos , América Latina/etnologia , Masculino , Pessoa de Meia-Idade , Parceiros Sexuais , Infecções Sexualmente Transmissíveis/diagnóstico , Espanha/epidemiologiaRESUMO
In Spain, neither the HIV nor the STI national surveillance systems collect information on HIV/STI co-infection. However, there are two networks based on HIV/STI clinics which gather this data. We describe HIV prevalence in men who have sex with men (MSM) diagnosed with infectious syphilis and/or gonorrhoea in 15 STI clinics; and concurrent diagnoses of STI in MSM newly diagnosed with HIV in 19 HIV/STI clinics. In total, 572 MSM were diagnosed with infectious syphilis and 580 with gonorrhoea during 2005-2007. HIV prevalence among syphilis and gonorrhoea cases was 29.8% and 15.2% respectively. In the multivariate analysis, HIV/syphilis co-infection was associated with being Latin American; having a history of STI; reporting exclusively anal intercourse; and having sex with casual or several types of partners. HIV and gonorrhoea co-infection was associated with age older than 45 years; having no education or only primary education completed; and having a history of STI. In total, 1,462 HIV infections were newly diagnosed among MSM during 2003-2007. Of these, 31.0% were diagnosed with other STI at the same time. Factors associated with STI co-infection among new HIV cases in MSM were being Latin American; and having sex with casual partners or with both steady and casual partners. In Spain, a considerable proportion of MSM are co-infected with HIV and STI.
Assuntos
Surtos de Doenças/estatística & dados numéricos , Infecções por HIV/epidemiologia , Homossexualidade Masculina/estatística & dados numéricos , Adulto , Humanos , Incidência , Masculino , Vigilância da População , Medição de Risco , Fatores de Risco , Espanha/epidemiologiaRESUMO
A serologic survey of Trichinella infection was carried out to determine the prevalence of this parasitosis among wild mammals kept in captivity at the Chapultepec Zoo. This was prompted by the necropsy finding of a heavy Trichinella infection in a Canadian polar bear (Ursus maritimus) that had been kept at the Zoo for more than 11 years. The parasites recovered were identified as T. nativa (T2). A serologic study based on ELISA and Western blot analysis was performed in serum samples from two polar bears (U. maritimus), six wolves (Canis lupus); nine foxes (Urocyon cinereoargenteus); seven coyotes (Canis latrans); nine jaguars (Panthera onca); ten lions (Panthera leo); 11 tigers (Panthera tigris); six panthers (Panthera pardus); eight leopards (Panthera pardus); two lynxes (Lynx rufus); five pumas (Felis concolor); one yagouaroundi (Felis yagouaroundi); and one ocelot (Felis pardalis). In these assays, 25% and 27% of the samples studied were positive using total muscle larva extract from T. nativa (T2) or T. spiralis (T1), respectively. When T. spiralis (T1) excretory/secretory products or surface/stichosomal antigens were used, 15 and 13% positivity was obtained respectively. The reactivity rates obtained among the different groups varied from 11 to 83%, wolves having the highest infection rate. Western blot analysis of positive ELISA sera showed an antigenic recognition pattern characteristic of animals infected with Trichinella.