Self-rated health among people living with HIV in Spain in 2019: a cross-sectional study.

BACKGROUND: HIV infection has become a chronic disease and well-being of people living with HIV (PLHIV) is now of particular concern. The objectives of this paper were to describe self-rated health among PLHIV, on ART and on ART virally suppressed and to analyse its determinants. METHODS: Data were obtained from a second-generation surveillance system based on a cross-sectional one-day survey in public hospitals. Epidemiological and clinical data were collected among HIV-infected inpatients and outpatients receiving HIV-related care the day of the survey in 86 hospitals in 2019. Self-rated health was measured using a question included in the National Health Survey: "In the last 12 months, how would you rate your health status?" an ordinal variable with five categories (very good, good, moderate, bad and very bad). For the analysis, these responses were dichotomized into two categories: 1 = very good/good and 0 = moderate, bad or very bad health status. Factors associated with very good/good self-rated health were estimated using logistic regression. RESULTS: Of 800 PLHIV, 67.5% perceived their health as very good/good, 68.4% among PLHIV on ART and 71.7% of those virally suppressed. Having university education (adjusted odds ratio (aOR):2.1), being unemployed (aOR:0.3) or retired (aOR:0.2), ever being diagnosed of AIDS (aOR:0.6), comorbidities (aOR:0.3), less than 2 year since HIV diagnosis (aOR:0.3) and not receiving ART (aOR:0.3) were associated with good self-rated health. Moreover, among PLHIV on ART, viral load less than 200 copies (aOR:3.2) were related to better perceived health. Bad adherence was inversely associated with good self-rated health among PLHIV on ART (aOR:0.5) and of those virally suppressed (aOR:0.4). CONCLUSIONS: Nearly seven in 10 PLHIV in Spain considered their health status as very good/good, being higher among virally suppressed PLHIV. Both demographic and clinical determinants affect quality of life.

Determinantes de la asistencia irregular a consulta médica en pacientes con infección por el virus de la inmunodeficiencia humana: resultados de la Encuesta Hospitalaria de pacientes con el virus de la inmunodeficiencia humana, 2002-2012 / Factors determining irregular attendance to follow-up visits among human immunodeficiency virus patients: Results of the hospital survey of patients infected with human immunodeficiency virus

INTRODUCCIÓN: Describir la frecuencia de la asistencia irregular a consulta médica de pacientes con VIH y analizar sus determinantes. MÉTODOS: Estudio transversal realizado anualmente (2002-2012) en un día prefijado. Se recogen datos epidemiológicos, clínicos y conductuales de los pacientes con VIH (hospitalizados y ambulatorios) atendidos ese día en los hospitales públicos participantes. Se definió «asistencia irregular a consulta» como asistencia a consulta de forma esporádica, según la valoración del médico. Se realizó un análisis descriptivo, bivariante y multivariante de regresión logística para estimar los factores asociados a asistencia irregular a la consulta. RESULTADOS: En total se incluyeron 7.304 pacientes de los que el 13,7% acudían irregularmente a la consulta. La probabilidad de asistencia irregular aumentó en pacientes entre 25 y 49 años, subsaharianos o latinoamericanos, con menor nivel de estudios, aquellos sin domicilio fijo o que estaban en prisión, los que vivían solos o en establecimientos colectivos, los desempleados o jubilados, los que se infectaron por compartir material de inyección, los que no usaron condón en su última relación sexual y los inyectores activos. Por el contrario, los pacientes diagnosticados hacía menos de un año y los hombres homo/bisexuales tenían menor probabilidad de acudir irregularmente. CONCLUSIÓN: A pesar de la universalidad de nuestro sistema de salud existen variables sociales y demográficas que actúan como barreras para la asistencia a consulta, lo que puede comprometer la efectividad del tratamiento en determinados grupos de población. Estos determinantes deberían tenerse en cuenta a la hora de planificar políticas de control de la infección por el VIH

INTRODUCTION: To describe the occurrence of non-regular attendance to follow-up visits among HIV patients and to analyze the determining factors. METHODS: One-day survey carried out annually (2002-2012) in public hospitals. Epidemiological, clinical and behavioral data are collected in all HIV-infected inpatients and outpatients receiving HIV-related care on the day of the survey. «Non-regular attendance to a follow-up visit» was defined as sporadic attendance to the medical appointments, according to the judgment of the attending physician. Descriptive and bivariate analyses were performed, and factors associated to non-regular attendance to follow-up visits were estimated using logistic regression. RESULTS: A total of 7,304 subjects were included, of whom 13.7% did not attend medical appointments regularly. Factors directly associated with non-regular attendance were: age between 25-49 years; birth in Sub-Saharan Africa or Latin-America; low educational level; being homeless or in prison; living alone or in closed institutions; being unemployed or retired; being an intravenous drug user; not using a condom at last sexual encounter, and injecting drugs in the last 30 days. Conversely, HIV diagnosis within the last year and being men who have sex with men were factors inversely associated with non-regular attendance to follow-up visits. CONCLUSION: In spite of health care beings free of charge for everyone in Spain, social factors can act as barriers to regular attendance to medical appointments, which, in turn, can endanger treatment effectiveness in some population groups. This should be taken into account when planning HIV policies in Spain

[Factors determining irregular attendance to follow-up visits among human immunodeficiency virus patients: results of the hospital survey of patients infected with human immunodeficiency virus]. / Determinantes de la asistencia irregular a consulta médica en pacientes con infección por el virus de la inmunodeficiencia humana: resultados de la Encuesta Hospitalaria de pacientes con el virus de la inmunodeficiencia humana, 2002-2012.

INTRODUCTION: To describe the occurrence of non-regular attendance to follow-up visits among HIV patients and to analyze the determining factors. METHODS: One-day survey carried out annually (2002-2012) in public hospitals. Epidemiological, clinical and behavioral data are collected in all HIV-infected inpatients and outpatients receiving HIV-related care on the day of the survey. "Non-regular attendance to a follow-up visit" was defined as sporadic attendance to the medical appointments, according to the judgment of the attending physician. Descriptive and bivariate analyses were performed, and factors associated to non-regular attendance to follow-up visits were estimated using logistic regression. RESULTS: A total of 7,304 subjects were included, of whom 13.7% did not attend medical appointments regularly. Factors directly associated with non-regular attendance were: age between 25-49 years; birth in Sub-Saharan Africa or Latin-America; low educational level; being homeless or in prison; living alone or in closed institutions; being unemployed or retired; being an intravenous drug user; not using a condom at last sexual encounter, and injecting drugs in the last 30 days. Conversely, HIV diagnosis within the last year and being men who have sex with men were factors inversely associated with non-regular attendance to follow-up visits. CONCLUSION: In spite of health care beings free of charge for everyone in Spain, social factors can act as barriers to regular attendance to medical appointments, which, in turn, can endanger treatment effectiveness in some population groups. This should be taken into account when planning HIV policies in Spain.