Author(s):
Abrantes, Ricardo ; Pimentel, Victor ; Miranda, Mafalda N. S. ; Silva, Ana Rita ; Diniz, António ; Ascenção, Bianca ; Piñeiro, Carmela ; Koch, Carmo ; Rodrigues, Catarina ; Caldas, Cátia ; Morais, Célia ; Faria, Domitília ; Gomes da Silva, Elisabete ; Teófilo, Eugénio ; Monteiro, Fátima ; Roxo, Fausto ; Maltez, Fernando ; Rodrigues, Fernando ; Gaião, Guilhermina ; Ramos, Helena ; Costa, Inês ; Germano, Isabel ; Simões, Joana ; Oliveira, Joaquim ; Ferreira, José ; Poças, José ; Soares, Jorge ; Saraiva da Cunha, José ; Fernandes, Sandra ; Mansinho, Kamal ; Pedro, Liliana ; Aleixo, Maria João ; Gonçalves, Maria João ; Manata, Maria José ; Mouro, Margarida ; Serrado, Margarida ; Caixeiro, Micaela ; Marques, Nuno Miguel ; Costa, Olga ; Pacheco, Patrícia ; Proença, Paula ; Rodrigues, Paulo ; Pinho, Raquel ; Tavares, Raquel ; Correia de Abreu, Ricardo ; Côrte-Real, Rita ; Serrão, Rosário ; Sarmento e Castro, Rui ; Nunes, Sofia ; Faria, Telo ; Baptista, Teresa ; Simões, Daniel ; Mendão, Luis ; Martins, M. Rosário O. ; Gomes, Perpétua ; Pingarilho, Marta ; Abecasis, Ana B.
Date: 2024
Persistent ID: http://hdl.handle.net/10362/172719
Origin: Repositório Institucional da UNL
Subject(s): drug resistance; HIV-1; late presentation; men who have sex with men; Portugal; vulnerable populations; Public Health, Environmental and Occupational Health; SDG 3 - Good Health and Well-being
Description
Funding Information: The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by the European funds through grant Bio-Molecular and Epidemiological Surveillance of HIV Transmitted Drug Resistance, Hepatitis Co-Infections and Ongoing Transmission Patterns in Europe (BEST HOPE) (project funded through HIVERA: Harmonizing Integrating Vitalizing European Research on HIV/AIDS, grant no: 249697); by FCT for funds to GHTM-UID/Multi/04413/2013, GHTM-UID/04413/2020 and LA-REAL - LA/P/0117/2020; by the MigrantHIV project (financed by FCT: PTDC/DTP-EPI/7066/2014); by Characterization of drug-resistance TB and HIV, and associated sociobehavioral factors among migrants in Lisbon, Portugal project financed by GHTM-UID/Multi/04413/2013; by Integriv project (financed by FCT: PTDC/SAUINF/31990/2017) and the MARVEL project (financed by FCT: PTDC/SAU-PUB/4018/2021). This study was financed by the Gilead Génese programme through funding to project HIVLatePresenters. Publisher Copyright: Copyright © 2024 Abrantes, Pimentel, Miranda, Silva, Diniz, Ascenção, Piñeiro, Koch, Rodrigues, Caldas, Morais, Faria, Gomes da Silva, Teófilo, Monteiro, Roxo, Maltez, Rodrigues, Gaião, Ramos, Costa, Germano, Simões, Oliveira, Ferreira, Poças, Saraiva da Cunha, Soares, Fernandes, Mansinho, Pedro, Aleixo, Gonçalves, Manata, Mouro, Serrado, Caixeiro, Marques, Costa, Pacheco, Proença, Rodrigues, Pinho, Tavares, Correia de Abreu, Côrte-Real, Serrão, Sarmento e Castro, Nunes, Faria, Baptista, Simões, Mendão, Martins, Gomes, Pingarilho, Abecasis and the BESTHOPE Study Group.
Introduction: HIV late presentation (LP) remains excessive in Europe. We aimed to analyze the factors associated with late presentation in the MSM population newly diagnosed with HIV in Portugal between 2014 and 2019. Methods: We included 391 newly HIV-1 diagnosed Men who have Sex with Men (MSM), from the BESTHOPE project, in 17 countrywide Portuguese hospitals. The data included clinical and socio-behavioral questionnaires and the viral genomic sequence obtained in the drug resistance test before starting antiretrovirals (ARVs). HIV-1 subtypes and epidemiological surveillance mutations were determined using different bioinformatics tools. Logistic regression was used to estimate the association between predictor variables and late presentation (LP). Results: The median age was 31 years, 51% had a current income between 501–1,000 euros, 28% were migrants. 21% had never been tested for HIV before diagnosis, with 42.3% of MSM presenting LP. 60% were infected with subtype B strains. In the multivariate regression, increased age at diagnosis, higher income, lower frequency of screening, STI ever diagnosed and higher viral load were associated with LP. Conclusion: Our study suggests that specific subgroups of the MSM population, such older MSM, with higher income and lower HIV testing frequency, are not being targeted by community and clinical screening services. Overall, targeted public health measures should be strengthened toward these subgroups, through strengthened primary care testing, expanded access to PrEP, information and promotion of HIV self-testing and more inclusive and accessible health services.
