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. 2015 Nov 3:15:496.
doi: 10.1186/s12879-015-1230-3.

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

D Van Beckhoven  1 , E Florence  2 , J Ruelle  3 , J Deblonde  4 , C Verhofstede  5 , S Callens  6 , E Vancutsem  7 , P Lacor  8 , R Demeester  9 , J-C Goffard  10 , A Sasse  11 ; BREACH Belgian Research on AIDS and HIV Consortium
Collaborators, Affiliations

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

D Van Beckhoven et al. BMC Infect Dis. .

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.

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Figures

Fig. 1
Fig. 1
Diagram representing the distribution of the HIV diagnosed population within the continuum of HIV care
Fig. 2
Fig. 2
Distribution of delay between HIV diagnosis and first medical contact in HIV care (recorded CD4 or VL) among patients entered in care
Fig. 3
Fig. 3
Estimated percentage of diagnosed HIV individuals living in Belgium by stage of the continuum of HIV care, 2011
See this image and copyright information in PMC

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