Although Spain has managed to reduce new HIV diagnoses over the past decade, the delay in detection of the disease remains a critical public health problem, according to the latest report from the National Center for Epidemiology of the Carlos III Health Institute. In 2023, 3,196 new cases were recorded, consolidating a downward trend that began in 2013 in the face of the uncontrolled increase in other sexually transmitted diseases. However, the report focuses on a persistent problem: late diagnosis, which affects about half of cases and increases significantly with age.
Nearly half of people diagnosed with HIV in 2023, or 48.7%, were diagnosed late, meaning the infection had already progressed significantly. In addition, this late diagnosis increases with age, while among those under 25, late diagnosis occurred in 33.4% of cases, this figure rises to 61.5% among people over 50 years old, who were mainly infected through heterosexual relations. The stigma here works in the opposite direction: as these groups have fewer cases, they are not expected to carry the virus. And this makes it difficult to identify beforehand.
The main route of transmission remains sexual, representing 80.7% of cases. In this context, men who have sex with men (MSM) represent 55% of diagnoses, followed by heterosexual relations (25.7%) and injecting drug use (1.7%).
The analysis also highlights that inequalities in access to diagnosis are also significant: 49.8% of new diagnoses correspond to people born outside of Spain, with an even higher percentage among women (61.6%). .
An opposite trend
While HIV is on the decline, sexually transmitted diseases (STDs) such as gonorrhea, syphilis and chlamydia are on the rise. According to the National Epidemiological Surveillance Network (RENAVE), cases of gonorrhea increased by 42.6% between 2021 and 2023, reaching record numbers. The same goes for syphilis, which recorded 24.1% more cases in 2023 than two years ago.
The Ministry of Health said that STIs “constitute a major public health problem, both because of their magnitude and their complications and consequences if early diagnosis and treatment are not carried out”, linking this increase to global trends and improving health systems. . However, the proposal from Mónica García’s team to distribute free condoms to young people, announced a year ago to mitigate the increase in STIs, is still not implemented.
