Characteristics and outcome of HIV infection in gypsies in the Spanish VACH Cohort

• Published in: Enfermedades infecciosas y microbiologia clinica Vol. 28; no. 5; pp. 266 - 272
• Main Authors: Teira, Ramón, Suárez-Lozano, Ignacio, Lozano, Fernando, Viciana, Pompeyo, Domingo, Pere, Galindo, Pepa, Geijo, Paloma, Terrón, Alberto, González, Juan, Cosín, Jaime, Ribera, Esteban, Roca, Bernardino, García-Alcalde, María L, Sánchez, Trinitario, Muñoz-Sánchez, Agustín, Vergara, Antonio, López-Aldeguer, José, Pedrol, Enric, Vidal, Francesc, Garrido, Myriam, Santamaría, Juan M
• Format: Journal Article
• Language: English
• Published: Spain Elsevier Espana 01.05.2010
• Subjects: Adult; Cross-Sectional Studies; Desigualdades; Epidemiology; Epidemiología; Ethnic groups; Factores socioeconómicos; Female; Gitanos; Grupos étnicos; Gypsies; HIV disease progression; HIV infection; HIV Infections - epidemiology; Humans; Inequalities; Infectious Disease; Male; Minority groups; Minorías; Progresión de la enfermedad por VIH; Roma; Socioeconomic factors; Spain; VIH; Spain; Epidemiología; HIV disease progression; Minority groups; Epidemiology; Desigualdades; Progresión de la enfermedad por VIH; VIH; Gitanos; Factores socioeconómicos; Gypsies; Socioeconomic factors; Ethnic groups; Inequalities; Grupos étnicos; Minorías; HIV infection
• ISSN: 0213-005X; 1578-1852
• DOI: 10.1016/j.eimc.2009.04.018

Abstract Objective To study the characteristics of HIV infection in the gypsy (Roma) population in Spain, as compared with those of the Caucasian, non-gypsy majority. Design Cross-sectional, historical cohort study from the Spanish VACH Cohort. Methods Patients attending VACH clinics between 1 June 2004 and 30 November 2004 were classified according to their racial and ethnic origin as “gypsies”, Caucasian non-gypsy Spanish natives (CNGN), and “other” (the last being excluded from this study). Their sociodemographic and clinico-epidemiological characteristics were compared, as well as the Kaplan–Meier curves of time to AIDS, or death, or disease progression (either of the 2 outcomes). Results 4819 (48%) of 10,032 cases included in the VACH database were eligible: 210 (4.2%) were gypsies and 4252 (84.8%) were CNGN. Differences were observed in age, household, academic, inmate, marital, and employment history. Injecting drug use had been the most frequent mechanism of transmission in both groups, but to a greater extent among gypsies (72% versus 50%; P< 0.000). Sex distribution, CD4 cell counts, and viral loads at the first visit were similar in the 2 groups, as was the percentage of patients with previous AIDS, percentage receiving antiretrovirals, and percentage subsequently starting antiretroviral therapy. Up to 1 April 2005, 416 new AIDS cases and 85 deaths were recorded. The percentage of these outcomes did not differ between groups, but log-rank test showed a shorter time to AIDS and disease progression among gypsies. Conclusions The sociodemographic characteristics of gypsies, the largest minority in the VACH Cohort, show differences relative to those of CNGN. HIV-related outcomes suggest that gypsies have a poorer prognosis.