Prevalence of the HIV infection in patients seen at specialized diagnosis centers in 9 cities in Spain from 1992 to 2001

To describe the prevalence of HIV infection in persons tested between 1992 and 2001. Descriptive, cross-sectional epidemiological study. 10 ambulatory centers specialized in diagnosing HIV, located in 9 cities in Spain. 53,183 persons older than 12 years, tested for the first time for HIV. Number of persons tested per year, number of persons diagnosed as seropositive for HIV according to sex, age group and category of exposure. The number of persons tested increased from 4401 in 1992 to 6407 in 2001. Approximately half reported heterosexual risk exposure/exposure through high-risk heterosexual behaviors, excluding prostitution. Intravenous drug users (IVDU) increased from 15.3% in 1992-1993 to 1.4% in 2000-2001, and women prostitutes/female sex workers increased from 6.7% to 25.1%. A total of 2898 persons were diagnosed as having HIV infection; 78% of them were men. The number of diagnoses decreased from a high of 1058 in 1992-1993 to 304 in 2000-2001, and this trend was seen for all categories of exposure except female prostitutes and men with heterosexual risk factors. The prevalence decreased from 14% in 1992 to 2% in 2001. There were decreases in all categories of exposure, especially during the first years of the study, with a tendency to level off. In 2001 the prevalence figures were 23.8% for IVDU, 7.9% for homosexual men and women, 0.8% for female sex workers and 1% for other heterosexual men and women. The specialized diagnostic centers play an important role in diagnosing HIV, and this service complements primary care services. Greater efforts are needed in the prevention of HIV infection.