With more testing, HIV infections in Córdoba remain stable for five years

Number of infections in Cordoba Human immunodeficiency virus (HIV) is still around stable. According to data from the Ministry of Health in Córdoba, 15 people per 100,000 inhabitants in our province are infected with the virus, Ratios similar to those recorded over the past five yearswith some changes.

Among the encouraging data released by the province is the increasing number of tests and aggressive search strategies to detect people living with HIV and achieve treatment compliance.

However, vertical transmission from mother to newborn has increased over the past four years. Two positive neonatal cases have been confirmed so far this year (2023 coming soon). There were 4 cases in 2022, while no positive babies were recorded in 2021 and only 1 case in 2020.

“Regional activity has increased in recent years, as has the availability of rapid testing at health centres. There has also been an increase in the number of health agents now uploading information to the system. This active search may partly explain the cases reason for the increase,” said Laura Lopez, head of epidemiology at the province’s Ministry of Health.

stable indicator

The HIV infection rate per 100,000 inhabitants has remained stable over the past five years. In 2019, the indicator was 16.6, and in 2023, it was 15.3. If the last 10 years are taken into account, a small downward trend in volatility can be observed.

In terms of patients, the number of patients in Córdoba declined between 2013 and 2015. The indicator has since remained stable, falling again in 2020, likely due to lower notification rates of the pandemic.

closing the gender gap

For women, age at diagnosis is increasing. At the time of the outbreak, the average age was 26. Today he is over 40 years old. This refers to the age at which the person discovered they had HIV.

For men, the average age remains at 37.

“The gap between men and women is closing,” explained Mariela Ainete, director of the communicable diseases department at the province’s Ministry of Health.

Diosnel Bouchet, coordinator of the provincial program to combat HIV/AIDS and sexually transmitted diseases, emphasized that prevention strategies are developed according to age groups. He added that health workers were trained mainly for adolescents, stressing that rapid tests can detect not only HIV but also syphilis, hepatitis B and hepatitis C.

This year, however, the availability of free condoms has been reduced for various reasons. Sometimes national production is interrupted due to lack of raw materials, sometimes national deliveries are also interrupted. In other cases, the province struggled to make purchases due to a lack of suppliers.

Last year, the province distributed 3.1 million free condoms, but this has dropped to 1.9 million so far this year.

Regarding gender disparity, approximately one out of every two men living with HIV is currently a woman. In 1985, the ratio of women to men was 1:19. The trend is national.

“In the beginning, it was an epidemic of men who have sex with men. Then it became more heterosexual and expanded through cisgender men and women. And then it was passed on to children through vertical transmission,” Boucher explained.

Today, 56.9% of cases are transmitted through heterosexual relationships, while 42.6% are transmitted through homosexual relationships. 0.5% is transmitted by sharing syringes in drug abuse situations.

post-pandemic mortality

The mortality indicator fluctuates the most. An alarming fact is that 2021 set a record with 1.8 deaths per 100,000 inhabitants. The number for men was 2.7.

Health authorities explained that this indicator is related to death records. HIV is not always reported as a cause of death. After the pandemic ended, we launched work to improve data quality.

Analía Cudolá, Minister of Prevention and Health Promotion, explained that the increase in HIV deaths registered in 2021 is due to several reasons. “This may be due to registration, but also due to the Covid-19 pandemic, which brings complications with all conditions. “This happens all over the world. “

Delegates highlighted a decrease in the percentage of late tests in Córdoba. Today, 17.8% of men and 13.1% of women find themselves infected when their body’s defenses are already low (fewer than 200 CD4 defense cells). Bouchet stressed that this strategy allows for early intervention and rapid action.

What happens in mother-to-child transmission?

In 2022, the vertical transmission rate is 3.54. In absolute numbers, 113 exposed newborns of positive mothers were studied in the public system, of whom 4 infants were diagnosed with HIV. The virus is passed from mother to son.

In 2021, 126 cases were studied and none were positive. In 2020, 136 exposed children were analyzed, and one child was diagnosed. The mother-to-child transmission rate is 0.74.

The number of pregnant women infected with HIV also increased slightly last year. This number increased from 88 in 2021 to 91 in 2022. 94% of pregnant women receive antiretroviral treatment, and 100% of newborns born to positive mothers this year receive perinatal prophylaxis, with different plans based on risk.

Health authorities say there are extremely vulnerable groups, such as homeless people, who are difficult for health systems to recruit. And it is necessary to analyze this metric over time to assess trends. “The rate of mother-to-child transmission has returned to levels similar to those recorded before the pandemic,” Lopez said.

The World Health Organization has set a ratio of less than two as the millennium goal.

The strategy is to encourage HIV-infected women to undergo preconception counseling and ongoing testing of couples.

“The biggest addition that this pandemic has left us with is the surveillance team. At that time, they were the agents monitoring the status of Covid-19 patients. Today we continue this model to monitor mothers and children diagnosed with STDs ,” Lopez said.

Where to consult

Rapid tests for HIV, syphilis, hepatitis B and C are available at primary care centres. They are also used for outside events such as football games and recitals.

Those interested in obtaining diagnosis or treatment can make an appointment by calling 351-2063974 via WhatsApp or visit Rosen Hospital from 8 a.m. to 12 noon. It is also possible to visit in person the Department of Preventive Medicine (7:30 am to 1:30 pm) at Santa Rosa Street. 360, from the city of Córdoba.

Internally, please contact the Testing Center via this link.

This year, 6,794 people have been registered in the public system for antiretroviral treatment. Of those, 6,128 (90%) stopped taking their medication within the past three months, and the remainder were considered “inactive.”

Additionally, the province began distributing antiretroviral drugs to people who are not infected with HIV to reduce the likelihood of infection. This is pre-exposure prophylaxis (Prep), and a total of 292 people in Córdoba received this treatment.

This strategy focuses specifically on key personnel or those who pose significant risks. It is not a replacement for condoms.

In the prevention package, the state provides vaginal condoms to provinces and then distributes them to municipalities.