Community-based screening of hepatitis C with a one-step RNA detection algorithm from dried-blood spots: Analysis of key populations in Barcelona, Spain.

Alternative strategies are required to enhance the diagnosis of silent hepatitis C virus (HCV) infections in key populations at risk. Among them, HCV prevalence and bio-behavioural data are scarce for HIV-negative men who have sex with men (MSM) and men and trans-women sex workers. We sought to describe and assess the potential benefits of a community-based one-step HCV screening and confirmatory strategy for these populations in Barcelona. The screening strategy based on a real-time RT-PCR assay for HCV-RNA detection in dried-blood spots (DBS) was validated and implemented in addition to an antibody point-of-care test in a community centre. HCV prevalence was assessed, and bio-behavioural data were collected. The molecular assay was precise, reproducible, sensitive and specific. Four HIV-negative MSM reported being currently infected (0.75% HCV self-reported prevalence). Implementation of DBS testing was easy, and acceptability was >95%, but no silent HCV case was diagnosed (N = 580). High-risk sexual practices and drug use for sex were reported frequently. HIV prevalence was 4.7% in MSM and 10% in sex workers. Self-reported prevalence of other STIs ranged from 11.3% to 36.2%. In conclusion, HCV-RNA testing in DBS showed a good performance, but the assessed one-step strategy does not seem beneficial in this setting. Although no silent HCV infections were detected, the observed high-risk behaviours and prevalence of other STIs suggest that HCV spread should be periodically monitored among these populations in Barcelona by means of behavioural surveillance, rapid antibody testing and molecular confirmation in DBS.

Awareness of Pre-exposure Prophylaxis for HIV, Willingness to Use It and Potential Barriers or Facilitators to Uptake Among Men Who Have Sex with Men in Spain.

There is a lack of data on pre-exposure prophylaxis (PrEP) effectiveness in Spain. We described the awareness of and willingness to use PrEP and examined potential barriers and facilitators to their use among men who have sex with men recruited either online or in voluntary HIV testing centers in Spain. Nearly a third of men (28.7 %) were aware of PrEP and 57.6 % said they would be willing to use it if available, 16.6 % saying they would be unwilling to use PrEP and 25.8 % not being sure. Men who had heard of PrEP were more forceful in their opinions on willingness to use PrEP (willing/not willing: 29.8 %/32.6 % vs. don't know: 21.8 %). The greatest consensus regarding more acceptable PrEP attributes was in the mode of delivery and its cost. Doctors (91 %) or pharmacists (85.3 %) were the preferred providers. The results confirm the need to inform and educate on PrEP and define implementation strategies.

Who are the men who have sex with men in Spain that have never been tested for HIV?

OBJECTIVES: The aims of the study were to describe the sociodemographic profile of men who have sex with men (MSM) who have never been tested for HIV and to analyse factors associated with never having been tested. METHODS: The European MSM Internet Survey (EMIS) was implemented in 2010 in 38 European countries on websites for MSM and collected data on sociodemographics, sexual behaviour, and other sexual health variables. A logistic regression analysis was conducted to assess variables associated with never having been tested for HIV. RESULTS: Of the 13,111 respondents living in Spain, 26% had never been tested for HIV. Those who had never been tested were significantly more likely to live in a settlement with fewer than 100,000 inhabitants, be younger than 25 years old, have a lower education level, be a student, and identify themselves as bisexual. In the multivariate analysis, to have never been tested for HIV was associated with being born in Spain [odds ratio (OR) 1.35; 95% confidence interval (CI) 1.192-1.539], living outside large settlements (OR 1.37; 95% CI 1.216-1.534), being younger than 25 years old (OR 2.94; 95% CI 2.510-3.441), being out to no one or only a few people (OR 2.16; 95% CI 1.938-2.399), having had no nonsteady partners in the last 12 months (OR 1.26; 95% CI 1.109-1.422), and being not at all confident to access HIV testing (OR 3.66; 95% CI 2.676-5.003), among others factors. CONCLUSIONS: The profile of the MSM who had never been tested for HIV indicates that most of them were men who were hard to reach (young, bisexual men, in the closet). Interventions should aim to improve access to and the convenience of testing.

Calidad de vida en pacientes con esquizofrenia de ascendencia étnica aymara en el norte de Chile / Quality of life of schizophrenia patients of aymaran ethnic background in the north of Chile

Objetivo:Se describe la calidad de vida en pacientes con esquizofrenia con ascendencia aymara, analizando la presencia de diferencias con pacientes de ascendencia no originaria. Método:Participaron 45 pacientes atendidos por los Servicios de Salud Mental de Arica, Chile. Se utilizó la Escala de Síntomas Positivos y Negativos (PANNSS), y el Cuestionario Sevilla de Calidad de Vida (CSVV). Resultados:Los pacientes del estudio mostraron niveles moderados de calidad de vida, con una fuerte relación con el síndrome negativo y la psicopatología general del trastorno, no hallando diferencias significativas en las dimensiones de la calidad de vida en función de la ascendencia étnica. Los resultados encontrados evidencian que la integración de los pacientes a los servicios de salud comunitarios se asocia positivamente a la valoración que hacen respecto a su calidad de vida, siendo fundamental considerar la integración de los cuidadores en los tratamientos administrados(AU)

Objective:To describe the quality of life of patients of Aymaran descent with schizophrenia and analyse the differences with patients of non-Aymaran descent. Method:The study included 45 patients who attended the Mental Health Services in Arica, Chile. The Positive and Negative Syndrome Scale (PANSS) and the Seville Quality of Life Questionnaire (SQoLQ) were used. Results:The patients of the study showed moderate quality of life levels, with a strong association with the negative syndrome and the general psychopathology of the disorder. No significant differences were found in the quality of life dimensions as regards ethnic background. Conclusions:The results found demonstrate that the integration of patients in the Community Health Services is positively associated as regards their quality of life. The integration of the caregivers is considered essential in the treatments administered(AU)