Ramis-Juan, Oriol

Revistes Catalanes amb Accés Obert

M E D I C I N E  
AIDS IN CATALONIA 
THE PROPORTION OF SUFFERERS WHO ARE DRUG ADDICTS IS 
MUCH HIGHER IN CATALONIA THAN IN THE U.S.A. OR THE REST 
OF EUROPE. THE ILLNESS HAS SPREAD MOST NOTICEABLY IN 
THOSE GROUPS WHERE PREVENTIVE MEASURES ARE MORE 
DIFFICULT TO APPLY. 
O R I O L R A M I S - J U A N  L O N D O N  S C H O O L  O F  H Y G I E N E  A N D  T R O P I C A L  M E D I C I N E  
n ccording to estimates put for- ward at the recent Internatio- nal Conference on AIDS, held 
in Paris last June, some 20,000 people 
have been affected by this disease in 
the industrialized countries. In the 
Spanish state the incidence of this new 
illness is still less than a twentieth of that 
in the U.S., where more tham 85 % of 
cases in al1 the advanced countries are 
concentrated, but the number of suffe- 
rers everywhere is continually in- 
creasing. 
Luckily, in the last few months we have 
been able to see important advances. 
French and American investigators have 
discovered the important aetiological 
role played by a virus known as H.I.V. 
(Human Immunodefficiency-linked Vi- 
rus). This has meant an important step 
forward in research. Nevertheless, 
many years will have to pass before we 
can come up with an efficient vaccine. 
The length of time necessary before we 
find a suitable treatment is even more 
uncertain, but it will also be considerab- 
le. On the other hand, we have a good 
knowledge of the means of contagion. 
The virus is transrnitted by the adminis- 
tration of blood from an infected per- 
son to someone else, through genital 
contact, or, during pregnancy, from 
mother to child. The first form of conta- 
gion explains why the illnes is so often 
present in haemophiliacs, who are 
constantly in need of blood transfusions 
from donations. Most cases of AIDS in 
haemophiliacs are due to blood trans- 
fusions which have come from untested 
donations made when the the nature of 
the syndrome was not yet known. Now 
that the action of the virus is understood 
and there are tests which will identify 
samples of infected blood, these cases 
should no longer arise: Catalonia, like 
the majority of European countries, has 
passed legislation to ensure that routine 
checks are carried out to detect evi- 
dence of contact with the virus in blood 
donations as well as in al1 industries 
dealing with haematic products. 
However, the maiority of transmissions 
via the blood appear in people addic- 
ted to the intravenously-administered 
drugs -especially heroin-, who tend to 
share needles and syringes amongst 
themselves. The traces of blood which 
remain on the syringes transmit the in- 
fection. 
Sexual transmission of the disease in 
industrialized countries is almost always 
limited to male homosexual relation- 
ships, possibly due to the minor iniuries 
which are typical of anal intercourse 
and other practices common in these 
relationships. In African countries, where 
though less frequently referred to, 
the number of AIDS sufferers is possibly 
much higher than in the U.S.A., hetero- 
sexual transmission is far more com- 
mon. However, for the time being, a 
satisfactory explanation for this fact has 
not been found. Outside the human 
body the virus rapidly becomes inac- 
tive, and this may explain why conta- 
gion does not take place through simple 
physical contact between infected and 
healthy people. As can be seen from 
the chart, the proportion of sufferers 
who are drug addicts is much higher in 
Catalonia than in the U.S.A. or the rest 
of Europe. This phenomenon is not easy 
to explain. A reasonable hypothesis is 
that the relatively recent arrival of the 
illness has led to its limitation, since in 
an early phase of the epidemic we be- 
came aware of its characteristics and of 
the possilities of prevention. It has 
spread most noticeably in those groups 
where preventive measures are more 
diffiiult to apply. The capacity of the 
health services and health education to 
influence environments where drug con- 
sumption is common are practically nil. 
AIDS in Catalonia, much more than in 
other industrialized countries, must be 
thought of as yet another aspect of the 
serious problem which drug addiction is 
for health. ¤ 
DlSTRlBUTlON OF AlDS CASES BY GROUPS AT RlSK IN U.S.A., EUROPE AND CATALONIA (Figures in percentages) 
RISK-GROUP U.S.A. EUROPE C A T A L O N I A  ' 
H o m o s e x u a l s  and b isexua ls  
Drug addicts 
Homosexuals ,  b isexua ls  and drug addicts 
Haemoph i l i acs  and transfusions 
Other or unknown 
T o t a l  1 0 0  1 0 0  1 O 0  


Aids in Catalonia

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Revistes Catalanes amb Accés Obert