Resumen

Purpose: A specific approach of HIV in adolescents is of global concern. Data about new HIV diagnoses in adolescents is scarce. Describing this population will contribute to better approach this problematic situation. Method: Description of HIV new diagnoses in patients 12-20 years-old included in CoRIS (adult) and CoRISpe (pediatric) Spanish cohorts until end 2017. Demographic, clinical, biological data and way of transmission were analysed. Results: For 357 adolescents, new HIV diagnosis was made; 75.4% were male. Median age at diagnosis was 18.7 years. Middle-adolescents (15-17 year-old) significantly increased, from 2003-2007 (16.4%) to 2013-2017 (25.2%, p=0.030). In 275 cases (77%) way of infection was sexual (53.5% men who have sex with men, MSM; 23.5% heterosexual contact), 54 (15.1%) drug users, 10 (2.8%) vertical transmission and 6 (1.7%) hemoderivates receivers. Sexual transmission and MSM increased significantly over time to 95.5% and 74.8% respectively in 2013-2017 (figure 1). The proportion of adolescents from total new HIV diagnoses in Spain significantly increased from 2005 (figure 2). Regarding the origin, 131 (36.7%) adolescents were born outside Spain; 71% of them in Latin-America. For Latin-American, in 93.5%, transmission was sexual vs 72.0% for other origins (p=0.0002). Late diagnosis (CD4< 350/mm³ or AIDS at diagnosis) was made for 123 adolescents (34.5%). This was more frequent for transmission by heterosexual contact (41.7%) than MSM (23.0%, p=0.0023). Late diagnoses among adolescents decreased over time but not in last 15 years: 21/67 (31.3%) in 2003-2017 vs 32/111 (28.8%) in 2013-2017 (p=0.74). Conclusion: There is an increasing contribution of sexual transmission and MSM in new HIV diagnoses in adolescents. HIV-newly infected adolescents are younger, with a growing rate of 15-17 year-old. More than 1/3 present late diagnosis and did not decrease in last 15 years. This emphasizes the vulnerability of this population and the need to develop more effective preventive actions.