CHANGES IN AIDS INCIDENCE TRENDS IN SPAIN

Objective: To detect changes in the evolution of the AlDS epidemic in Spain. Design: Analysis of time-trends in AIDS incidence. Methods: AIDS cases reported in Spain up to December 1993 were adjusted for reporting delays. Quarterly time-trends in incidence were analysed for groups divided according to sex, age and transmission category. Results: The adjusted number of cases diagnosed by September 1993 totalled 24519. Of these, 15652 were injecting drug users (IDU), 3679 were homosexual/bisexual men and 1753 were cases of heterosexually transmitted infection since 1989. AIDS incidence has exhibited a linear rate of growth. While all groups studied showed an upward trend, variations were found between the different groups. The overall trend resembled the pattern for IDU, the largest group. The heterosexual group displayed a lag compared with the other groups, but the slope in the growth curve for this category has steepened steadily, and experienced the greatest percentage increases since 1989. AIDS incidence among blood transfusion recipients has risen slowly since 1988, while that for blood-factor recipients reached a ceiling in 1989 and has declined progressively thereafter. Within the respective transmission categories, women exhibited trends similar to men. From 1989 onwards, a greater rate of increase was observed among those aged over 30 years than among those under 30. Conclusion: The overall trend in AIDS incidence is the sum of the epidemics in the different population groups. While advances in controlling the epidemic have been made in certain groups, the trend as a whole has worsened.