HIV infection among people of foreign origin voluntarily tested in Spain. A comparison with national subjects

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Abstract
Objectives: To describe exposure categories and HIV prevalence among subjects voluntarily tested in Spain by country of origin. Methods: HIV prevalence and exposure categories were compared between national and non-Spanish subjects voluntarily tested in 18 sexually transmitted disease/HIV testing clinics from 16 Spanish cities in 2000. Results: Of 8861 testers, 2810 (31.7%) came from foreign countries; 73.1% from Latin America, 9.1% from western Europe, 6.2% from central/eastern Europe, 4.4% from northern Africa, and 4.2% from sub-Sahara Africa. Among women from Latin America, 78% were sex workers compared to 5.5% Spanish women. HIV infection was diagnosed in 170 persons, 34.7% from foreign countries. HIV prevalence for Spanish subjects (23% for men and 1.0% for women) was significantly different from men and women from Latin America (11.3% and 0.3% respectively), Sub-Saharan Africa (9.1% and 7.5% respectively), and women from the north of Africa (11.8%). Compared with Spaniards, analyses of persons of the same exposure category showed higher HIV prevalence in men who had sex with men from Latin America (odds ratio: 4.1; 95% CI: 2.4–6.9), heterosexual men from sub-Sahara Africa (OR: 19.3; 95% CI: 6.4–58.0), and Latin America (OR: 9.4; 95% CI: 3.4–25.9), heterosexual women from sub-Sahara Africa (OR: 16.9; 95% CI: 3.5–82.4) and from northern Africa (OR: 15.3; 95% CI: 3.2–73.2). Conclusions: An important proportion of HIV testers from these clinics came from foreign countries and some groups showed a high prevalence of HIV infection. Specific prevention and testing programmes adapted to the needs of migrants in Spain should be developed.