Unequal access to HIV testing and prevention: "Immigrants' poor access" |

An interview with Maria Velasco, President of GeSIDA, analyzes the social and organizational barriers that still prevent universal access to prevention, early diagnosis and PrEP in Spain

Stigmatization remains one of the main forces driving universal access to HIV prevention and early diagnosis in Spain, despite scientific progress and the consolidation of more effective public health strategies.social Cultural and institutional barriers continue to hinder equity in early detection and access to care.Consequences include late diagnoses; the differences between regions and population groups and risk perceptions are still insufficient in large parts of the population.

In this context, the president of GeSIDA, María Velasco, showed in an interview what is preventing it from being tested."HIV labeling continues, for groups or individuals who are infected with this virus," he says.

Dr. Velasco emphasizes that this stigma prevents basic and necessary conversations in the consultation room."People are afraid to talk in a counseling center or with a doctor about the reality of sexual practices or the possibility of HIV infection," he points out.Added to this is a new problem: low risk perception in the heterosexual population, especially in those over 50, a group in which many late diagnoses are concentrated.According to him, this phenomenon affects citizens and experts, who are among these patients.Sex is often not resolved.

"Stigma makes people afraid to talk to doctors about the reality of sexual practices or the possibility of HIV infection."

The lack of absolute education is changed to the same level of life and cultures of the gesta, young people, you tell a limb to preventing and helpful.

Organizational barriers are also visible.Overload in primary care makes it difficult to find the time needed to address specific aspects related to sexual health and sexually transmitted infections (STIs).“In a very quick consultation, you can't have the conversation with the depth you need to have,” he complains.This situation results in the loss of the opportunity to request testing when there are grounds or antecedents that justify it.

The same offer of quick and easy communication in private communication, commitment, communication. I have nager guidelines in ng, Dr. Velasco "allow the work of testing" and further practice of training and compare it to its use in different countries.

Differences in immigrant populations

When it comes to immigrants, the situation is even more complicated.Although HIV infection has been included in the universal health care since Royal Decree 7/2018, administrative procedures, ignorance of the system or fear of legal consequences continue to create inequality. Dr. Velasco warns: "The immigrant population is not in the same situation as the Spaniards", a particularly relevant problem when half of new diagnoses occur in this group.

"Unbalanced settings between autonomous communities, waiting lists or regional differences have created irregular access"

The expert says there are also significant problems with access to pre-exposure prophylaxis (PrEP), a key prevention tool available.Uneven implementation, waiting lists or territorial differences between autonomous communities have led to irregular access.Dr. Velasco explains that GeSIDA is working to update its PrEP guidelines to incorporate new evidence and move toward more blended and decentralized delivery, with special attention to underrepresented populations that are more vulnerable or have more difficulty accessing PrEP.

Among the measures they propose, the need for monitoring more suitable to the profile of the user, the use of telemedicine in hard-to-reach places, the decentralization of distribution and the strengthening of specialist training.In addition, the president of GeSIDA insists on the importance of institutional campaigns and cooperation with non-governmental organizations to reach groups that have difficulty traveling.

Another important factor is the lack of expertise in infectious diseases, a Spanish specialty in Europe.The GeSIDA president warned that her absence does not ensure uniform training tours and threatens continuity of care in the face of impending generational change.Although they acknowledge that current care is of good quality, they warn that diversity in training could lead to the collapse of departments caring for people living with HIV.“It is a means of ensuring that future generations have this uniform education. We cannot ensure that every person living with HIV in Spain receives the same care,” he concluded.

*The content is prepared by journalists specialized in health and approved by a committee of top-level experts.However, readers are encouraged to ask health-related questions with a healthcare professional.