Good continuum of HIV care in Belgium despite weaknesses in retention and linkage to care among migrants

D Van Beckhoven, E Florence, J Ruelle, J Deblonde, C Verhofstede, S Callens, E Vancutsem, P Lacor, R Demeester, J-C Goffard, A Sasse, BREACH Belgian Research on AIDS and HIV Consortium

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    Abstract

    BACKGROUND: The Belgian HIV epidemic is largely concentrated among men who have sex with men and Sub-Saharan Africans. We studied the continuum of HIV care of those diagnosed with HIV living in Belgium and its associated factors.

    METHODS: Data on new HIV diagnoses 2007-2010 and HIV-infected patients in care in 2010-2011 were analysed. Proportions were estimated for each sequential stage of the continuum of HIV care and factors associated with attrition at each stage were studied.

    RESULTS: Of all HIV diagnosed patients living in Belgium in 2011, an estimated 98.2% were linked to HIV care, 90.8% were retained in care, 83.3% received antiretroviral therapy and 69.5% had an undetectable viral load (<50 copies/ml). After adjustment for sex, age at diagnosis, nationality and mode of transmission, we found lower entry into care in non-Belgians and after preoperative HIV diagnoses; lower retention in non-Belgians and injecting drug users; higher retention in men who have sex with men and among those on ART. Younger patients had lower antiretroviral therapy uptake and less viral suppression; those with longer time from diagnosis had higher ART uptake and more viral suppression; Sub-Saharan Africans on ART had slightly less viral suppression.

    CONCLUSIONS: The continuum of HIV care in Belgium presents low attrition rates over all stages. The undiagnosed HIV-infected population, although not precisely estimated, but probably close to 20% based on available survey and surveillance results, could be the weakest stage of the continuum of HIV care. Its identification is a priority along with improving the HIV care continuum of migrants.

    Original languageEnglish
    JournalBMC Infectious Diseases
    Volume15
    Pages (from-to)496
    ISSN1471-2334
    DOIs
    Publication statusPublished - 2015

    Keywords

    • Adult
    • African Continental Ancestry Group
    • Anti-Retroviral Agents
    • Belgium
    • Continuity of Patient Care
    • Drug Users
    • Female
    • HIV Infections
    • Health Surveys
    • Humans
    • Male
    • Patient Acceptance of Health Care
    • Transients and Migrants
    • Viral Load
    • Journal Article
    • Research Support, Non-U.S. Gov't

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