western europe (late): spain · 2019-10-16 · hiv in spain, 2017 people living with hiv1...
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Julia del AmoDirector of the National Plan against HIV and STIs
Western Europe (late): Spain
MINISTERIO
DE SANIDAD, CONSUMO Y
BIENESTAR SOCIAL
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• Epidemiology of HIV in Spain
• History of PrEP authorization in Spain
– Political Actions
– Administrative Actions
• Public health & policy governance in Spain
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HIV in Spain, 2017
People living with HIV1 140,000-170,000
HIV prevalence1 0.4%
Acumulated AIDS deaths (1981-2016)2 58,660
Acumulated AIDS cases (updated 30 June 2018)3 87,369
New HIV diagnoses in 2017 (rate adjusted by reporting delay, per 100 000 population)4 3,381 (8.8)
Sources: 1:Spectrum software (UNAIDS), 2: National Institute of Statistic, 3: National AIDS Registry, 4: New HIV diagnoses Information System,
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New HIV diagnoses, 2017New HIV diagnoses in Spain
Males (%) 84.6%
Male-to-female ratio 5.5/1
Percentage age 15-24 years 11.9%
Percentage age >50 years 14.8%
Transmission (%)
Sex between men 54,3
Heterosexual transmission 28,2
Injecting drug use 3,1
Mother to child transmission 0,2
Other 0,6
Unknown 13,6
Total cases 3,381
Source: : Spanish new HIV diagnoses Information System
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Rate of new HIV diagnoses per 100 000 population (adjusted for reporting delay), by year of diagnosis and transmission. Spain, 2009-2017
**Rates per 100 000 men
Year of diagnosis
Source: 17 Autonomous Regions(Aragón, Asturias, Baleares, Canarias, Cantabria, Castilla La Mancha, Castilla-León,
Cataluña, Extremadura, Galicia, La Rioja, Madrid, Murcia, Navarra, País Vasco, Ceuta and Melilla)
0
2
4
6
8
10
12
14
2009 2010 2011 2012 2013 2014 2015 2016 2017
MSM** Heterosexual IDU
Rate
per
100 0
00
Decreasing trend (2015-2017)
Stable trend (2009-2015)
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Proportion of delayed HIV diagnosis, 2017 (CD4<350 cels/mm3)
39.555.3
51.846.1
5045.9
63.550.5
51.941.6
65.2
54.947
36.531.1
50.647.2
47.8
0 10 20 30 40 50 60 70 80 90 100
North of AfricaSubsaharan Africa
Latin AmericaCentre-Eastern Europe
Western EuropeSpain
Heterosexuals menHeterosexuals women
Injecting drug usersMSM
>=5040-4930-3925-29
<25
WomenMen
Total
Source: Spanish new HIV diagnoses Information System
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History …
FDA
2012
WHO
2015
EMA
2016
AEMPS
2016
GeSIDA
2016
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History …
FDA
2012
WHO
2015
EMA
2016
AEMPS
2016
GeSIDA
2016
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What followed in 2017 ?
Need for a feasibility study in Spain
• December 2017 – December 2018
• Extended to October 2019
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What followed in 2018 ?First semester : Guidelines on PrEP issued by the MoH
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What followed in 2018 ?First semester : Guidelines on PrEP issued by the MoH
Last semester: Renewed impulse on PrEP within Governance bodies MoH
• National Committee of Public Health
• National Committee of regional coordinators of HIV
• National Committee of NGOs
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Health governance and decision making …
• National Committee of Public Health
• National Committee of regional coordinators of HIV
• National Committee of NGOs
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What followed in 2018 ?
Proposition not of Law in support of PrEP at the Health
Commission in the Spanish Parliament supported
unanimously by all political parties
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What followed in 2019 ?
First semester : Continued working within Governance bodies at MoH
• National Committee of Public Health
• Reactivated the National Commission of the AIDS Plan
(had not met since 2011)
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Health governance and decision making …
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What followed in 2019 ?
First semester : Continued working within Governance bodies at MoH
• National Committee of Public Health
• Reactivated the National Commission of the AIDS Plan (had not met since 2011)
• Active engagement with General Directorate of Pharmacy
Second semester: Continued working within Governance bodies at MoH
• National Committee of Public Health
• Active engagement with General Directorate of Pharmacy
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Health governance and decision making …
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What followed in 2019 ?
First semester : Continued working within Governance bodies at MoH
• National Committee of Public Health
• Reactivated the National Commission of the AIDS Plan (had not met since 2011)
• Active engagement with General Directorate of Pharmacy
Second semester: Continued working within Governance bodies at MoH
• National Committee of Public Health
• Active engagement with General Directorate of Pharmacy
• Approval of the inclusion of PrEP within Public Health System !!
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Thank you for your attention
MINISTERIO
DE SANIDAD, CONSUMO Y
BIENESTAR SOCIAL