actHIVa Cataluña: Consensus to improve comprehensive care and long-term quality of life for vulnerable people living with HIV in Catalonia

Abstract

Introduction

People living with HIV (PLHIV) in situations of vulnerability in Catalonia, including those born outside Spain, at risk of social exclusion, or older adults, face greater barriers related to social determinants, mental health, stigma, and clinical complexity, which affect their adherence to ART and continuity of care. ActHIVa Cataluña was created with the objective of identifying strategic priorities, aligned with the Pla d’acció enfront del VIH i altres ITS 2021–2030, aimed at improving their comprehensive care and long-term quality of life.

Methods

A multidisciplinary group of 16 experts was convened to identify and prioritise lines of action through consensus, alongside conducting a Health Impact Assessment (HIA) to evaluate the potential impacts on health and equity of the proposed actions.

Results

Twelve actions were agreed upon and grouped into four strategic objectives: early detection of risk determinants; assessment of quality of life and comprehensive care; strengthening of sociosanitary coordination; and involvement of PLHIV in decision-making. In a second phase, an HIA of the prioritized initiatives was carried out to estimate their potential effects on population health from an equity perspective.

Conclusion

The results highlight the potential of the proposed actions to strengthen comprehensive care and improve the quality of life of vulnerable PLHIV, enhancing their ART adherence and continuity of care, and supporting progress toward a more equitable, person-centred, and sustainable care model in Catalonia.