Resum

Background: The Treatment Cascade has been introduced to show that only 25% of PLWHIV maintain an undetectable viral load (USA-CDC). Improvement in every step of the cascade should be achieved. Methods: BCN Checkpoint is an HIV detection CBC for MSM in the gay area of Barcelona. Between 2009 and 2011 this centre detected 37% of all HIV cases reported in MSM in Catalonia, according to the National HIV Surveillance System. All reactive positive rapid tests during 2009 - 2012 were examined. Negative confirmatory tests (false positive) were excluded, as well as those who knew their serostatus and were already in care. Newly diagnosed were offered an appointment in a hospital's HIV unit. We also analyzed in 2011 and 2012 the time between diagnosis and appointment. Results: During the four years 14.949 tests and counseling sessions were performed with 517 positive results. We excluded 8 cases for being a false positive result and 14 cases for knowing their status and already being in care. Our review showed that, of the 495 newly diagnosed, 448 (90,5%) had an appointment in an HIV unit made by BCN Checkpoint. 17 cases (3,4%) decided to make their own appointment, because they knew somebody in a hospital or would go with another PLWHIV to their next doctor's visit. Some men (18 cases, 3,7%) were temporarily living in Barcelona and decided to seek care in their home country, of whom 78% within the EU. Finally, we were not able to contact during several intents 12 persons (2,4%), which we considered to be lost in the linkage to care. During 2011 and 2012 a total of 226 appointments were made. Time between diagnosis and appointment: = 7 days: 32%; 8-14 days: 20%; 15-21 days: 17%; 22-28 days: 16%; = 29 days: 15%. Conclusion: The model of intervention of BCN Checkpoint is highly effective in HIV detection. It also shows a high proportion of linkage to care, with direct hospital appointments in 90,5% of the cases, while only 2,4% of cases were lost. Appointments in less than 4 weeks were made for 85% of those linked to care.