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SDG 3: HIV/AIDS

Abstract

BACKGROUND

HIV screening strategies in alternative settings, such as emergency departments (EDs), aim to increase diagnosis of occult infections and achieve 95–95–95 targets for 2030.

AIM

To assess the effectiveness of an opt-in HIV screening strategy in EDs based on six clinical scenarios from a 2020 Spanish consensus document, while examining patient characteristics and linkage to-care.

METHODS

This descriptive, multicentre, retrospective study analysed epidemiological, clinical, and linkage-to-care data of individuals aged ≥ 18 years newly diagnosed with HIV between July 2021 and March 2024 in 17 EDs covering 73% of the population in Catalonia, Spain.

RESULTS

From 23,105 HIV serologies performed, there were 172 new diagnoses (positivity rate: 0.7%). Of these, 88.4% (152/172) were assigned male at birth, had a median age of 39 years (IQR: 30–50), and 47.9% (81/169) were Spanish. Sexual transmission was reported in 75.6% (130/172) of cases, with 55.5% (81/146) heterosexual. Fiebig stage data, available in 78.5% (135/172) of cases, showed 57.8% (78/135) had acute infection. Advanced HIV was found in 24.2% (30/124). Diagnoses related to the six clinical scenarios accounted for 54.6% (94/172) of cases. For all new diagnoses, 82.0% (137/167) were linked to specialised healthcare and started antiretroviral treatment within 9 days (IQR: 4–17), with no significant differences regarding urban/rural hospital coverage areas.

CONCLUSION

An opt-in HIV screening strategy in the ED is feasible and effective, especially in detecting highly transmissible patients with acute infection. However, one in five newly diagnosed individuals remained untreated, highlighting the need for improved linkage to care.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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/content/10.2807/1560-7917.ES.2025.30.47.2400781
2025-11-27
2026-04-21
/content/10.2807/1560-7917.ES.2025.30.47.2400781
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Characterisation of new HIV diagnoses achieved in emergency departments using an opt-in strategy, Catalonia, Spain, July 2021 to March 2024
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Jordi+Llaneras&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Llaneras Jordi</a>, <a href="/search?value1=Patricia+%C3%81lvarez-L%C3%B3pez&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Álvarez-López Patricia</a>, <a href="/search?value1=Roc%C3%ADo+de+Paz&option1=author&noRedirect=true" class="nonDisambigAuthorLink">de Paz Rocío</a>, <a href="/search?value1=M%C3%ADriam+Carb%C3%B3&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Carbó Míriam</a>, <a href="/search?value1=Mireia+Saura&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Saura Mireia</a>, <a href="/search?value1=Alexis+Rebollo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rebollo Alexis</a>, <a href="/search?value1=Cristina+Olaizola&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Olaizola Cristina</a>, <a href="/search?value1=Neus+Robert&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Robert Neus</a>, <a href="/search?value1=Alberto+Carrillo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Carrillo Alberto</a>, <a href="/search?value1=Cristina+Rami%C3%B3&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ramió Cristina</a>, <a href="/search?value1=Emma+Picart&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Picart Emma</a>, <a href="/search?value1=Josep+Maria+Guardiola&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Guardiola Josep Maria</a>, <a href="/search?value1=%C3%80lex+Smithson&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Smithson Àlex</a>, <a href="/search?value1=Ferran+Rodr%C3%ADguez-Masi%C3%A0&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rodríguez-Masià Ferran</a>, <a href="/search?value1=Connie+Leey&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Leey Connie</a>, <a href="/search?value1=Laura+Gonz%C3%A1lez-Garc%C3%ADa&option1=author&noRedirect=true" class="nonDisambigAuthorLink">González-García Laura</a>, <a href="/search?value1=Ignacio+Ferro&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ferro Ignacio</a>, <a href="/search?value1=Mariola+Michelini&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Michelini Mariola</a>, <a href="/search?value1=Margarita+Sotomayor&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sotomayor Margarita</a>, <a href="/search?value1=Ariadna+Rando-Segura&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rando-Segura Ariadna</a>, <a href="/search?value1=Adri%C3%A0+Curran&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Curran Adrià</a>, <a href="/search?value1=Emili+Gen%C3%A9&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gené Emili</a>, <a href="/search?value1=%C3%92scar+Mir%C3%B3&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Miró Òscar</a>, <a href="/search?value1=on+behalf+of+the+Urg%C3%A8ncies+VIHgila+group+of+the+Catalan+Society+of+Emergency+Medicine+%28SoCMUE%29&option1=author&noRedirect=true" class="nonDisambigAuthorLink">on behalf of the Urgències VIHgila group of the Catalan Society of Emergency Medicine (SoCMUE)</a></span>. Characterisation of new HIV diagnoses achieved in emergency departments using an opt-in strategy, Catalonia, Spain, July 2021 to March 2024. <a href="/content/ecdc">Euro Surveill.</a> 2025;30(47):pii=2400781. <a href="https://doi.org/10.2807/1560-7917.ES.2025.30.47.2400781" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2025.30.47.2400781</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 28 Nov 2024;&nbsp;&nbsp; <span class="generated">Accepted</span>: 26 May 2025 </span> </p>
/content/10.2807/1560-7917.ES.2025.30.47.2400781
/content/10.2807/1560-7917.ES.2025.30.47.2400781
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