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HIVDIS

Impact of socio-economical inequalities in the progression of HIV infection at individual and contextual level in Europe

Coordinatore	INSTITUTO DE SALUD CARLOS III Organization address address: CALLE SINESIO DELGADO 4-6 city: MADRID postcode: 28029 contact info Titolo: Mr. Nome: Pedro Cognome: Cortegoso Email: send email Telefono: 34918222764
Nazionalità Coordinatore	Spain [ES]
Totale costo	159˙365 €
EC contributo	159˙365 €
Programma	FP7-PEOPLE Specific programme "People" implementing the Seventh Framework Programme of the European Community for research, technological development and demonstration activities (2007 to 2013)
Code Call	FP7-PEOPLE-2010-IEF
Funding Scheme	MC-IEF
Anno di inizio	2012
Periodo (anno-mese-giorno)	2012-06-30 - 2014-06-29

Partecipanti

#	participant	country	role	EC contrib. [€]
1	INSTITUTO DE SALUD CARLOS III Organization address address: CALLE SINESIO DELGADO 4-6 city: MADRID postcode: 28029 contact info Titolo: Mr. Nome: Pedro Cognome: Cortegoso Email: send email Telefono: 34918222764	ES (MADRID)	coordinator	159˙365.60

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infected hiv explore density ethnic economic time barriers routinely contextual epidemic area aids individuals mortality determinants groups collected health disease eurocoord models socio newly income public patients progression

Obiettivo del progetto (Objective)

'Background. The HIV epidemic is a major public health issue in Europe. Over the last decade significant changes in the epidemic have taken place with a increasing proportion of HIV infections being in migrants and women. In turn, these groups might not fully benefit from life-saving antiretroviral treatments (ART), because of barriers to HIV testing and to ART. To date no study with sufficient sample size has explored the role of socio-economic determinants in heath of HIV infected patients in Europe. The role of contextual factors in the health of HIV patients, such as ethnic density, and lower area income level, have not been studied.

Objective. We aim to study the socio-economic determinants of inequalities in HIV diagnosis, disease progression, and treatment initiation in Western Europe. Moreover, we will explore the extent to which the variability of HIV prognosis is attributable to either individual (gender, ethnicity, social class) or contextual factors (income area, ethnic density). We will use the routinely collected data of HIV infected patients that will be merged by the newly established EuroCoord collaboration.

Methods. The routinely collected database from the newly established EuroCoord collaboration provides information on socio-economic determinants on 250,000 HIV infected individuals from various EU countries. HIV disease progression will be defined as rate of CD4 decline or time to AIDS or death. Marginal structural models to account for time varying confounding will be used to explore differences by socio-economic groups of the effect of ART on the risk of AIDS and mortality. Multilevel and latent variable models will be used to explore the role of contextual factors on HIV progression.

Public health implications. This research will help EU health care planners to identify and target groups of HIV infected individuals likely to face barriers to HIV testing and ART and thus prevent HIV-related mortality in more vulnerable populations.'