[HIV prevalence among homosexual and bisexual men in Spain, 1992-2000]. / Prevalencia del virus de la inmunodeficiencia humana en varones homosexuales y bisexuales, 1992-2000.

BACKGROUND: Our purpose was to describe the time trend in HIV seroprevalence among homo/ bisexual men. SUBJECTS AND METHOD: We analyzed 9,383 homo/ bisexual men who had a first voluntary test for HIV in 10 Spanish clinics from 1992 to 2000. RESULTS: HIV prevalence decreased from 20.3% in 1992 to 8.4% in 2000. In the multivariate analysis this decline appeared independently associated with the testing year and the birth cohort. CONCLUSIONS: New generations of voluntarily tested homo/bisexual men are less infected by HIV, but it is yet necessary to intensify the prevention programs.

[Trends in human immunodeficiency virus infection prevalence in homosexual/bisexual men in Madrid (1986-1995)]. / Evolución de la prevalencia de infección por el virus de la inmunodeficiencia humana en un colectivo de varones homo/bisexuales de Madrid (1986-1995).

BACKGROUND: We analysed the trend in seroprevalence for human immunodeficiency virus (HIV) in homosexual or bisexual men who voluntary requested the test in a sexually transmitted disease/HIV clinic in Madrid. PATIENTS AND METHODS: We studied 5,424 homo/bisexual non-injecting drug user (non-IDU) men, who came for the first time since 1986 to 1995. We analysed the HIV seroprevalence taken into account the year, age and exchange of sex by money. A hundred and thirty-six IDU homo/bisexual men were also attended during the same period and they were compared with non-IDU. RESULTS: HIV seroprevalence among the 5,424 non-IDU homo/bisexual men were 20.2%, rising from 19.6% in 1986 to 29.6% in 1990. After then, the trend decreased to 15.3% in 1995 (chi 2 for trend, 66.8; p < 0.0001). Average age was three years higher among seropositives (p < 0.0001), and showed an upward trend from 29.9 in 1986 to 34.6 in 1995 (p = 0.0059). Seroprevalence among homosexuals younger than 25 fell in the last years. One percent of individuals had ever practiced the prostitution. They were younger (average age, 27.6), and their HIV seroprevalence were 25.9%. A hundred and thirty-six IDU homo/bisexual men were also attended for the first time, being 2.4% of overall homo/bisexual men. They had a higher seroprevalence (48.5%) than non-IDU (p < 0.0001), and did not show any significative time-trend. CONCLUSIONS: A favourable evolution can be observed in HIV seroprevalence among homo/bisexual from Madrid, Spain, men who came to be tested, especially among the youngest. Prevention programs should make an effort to maintain this trend.

[Heterosexual transmission of HIV infection, Madrid 1987]. / Transmisión heterosexual de la infección por VIH, Madrid 1987.

Seven males of 132 (5%) and 9 females of 85 (10%) out of 217 heterosexual individuals without addiction to drugs or previous blood transfusion who attended a STD clinic in Madrid because they had high risk sexual partners were found to have antiHIV antibodies by ELISA and immunofluorescence (CNMVIS). However, when variables such as sex, promiscuity and sexual habits were correlated with HIV infection, significant differences were not found between seropositive and seronegative individuals (kappa 2, p greater than 0.05). Among the factors statistically linked with the infection (kappa 2, p less than 0.05) there were the previous STD and the sustained sexual intercourse with proven HIV seropositive individuals: there 8 infected individuals out of 40 with such type of partners (relative risk 4.4). On the other hand, the partners of individuals with unknown serological findings had the following results: 4 seropositive individuals out of 71 partners of parenteral drug abusers, 3 of 82 users of prostitutes, and 1 infected individual out of the 24 remaining ones (partners of bisexual individuals or combinations) (relative risk of each of them less than 1). These results show the importance of heterosexual, not mediated by blood, HIV transmission in couples of high risk persons, and they suggest that the infection is highly likely if sexual intercourse is maintained with infected individuals irrespective of their sex.