Person:
Iniesta-Marmol, Carlos

First Name

Carlos

Last Name

Iniesta-Marmol

Institution

ISCIII

Centrre

ISCIII::Escuela Nacional de Sanidad (ENS)

Identifiers

Full item page

Search Results

Now showing 1 - 10 of 11

La situación político-administrativa en España de la Profilaxis Pre-Exposición al VIH
(Instituto de Salud Carlos III (ISCIII). Centro Nacional de Epidemiología (CNE), 2018-01-18) Garcia-Sousa, Luis Miguel; Iniesta-Marmol, Carlos; Garrido, Jorge; Fuster, Maria Jose; Pujol, Ferran; Meulbroek, Michael; Poveda, Toni; Riera, Melchor; Antela, Antonio; Moreno, Santiago; Amo, Julia del
Antecedentes de la PrEP en España, contexto, metodología. Actividad institucional a nivel estatal: Ministerio de Sanidad, Servicios Sociales e Igualdad, cuestiones al Comité de Bioética, líneas de trabajo del MSSSI. Profilaxis. Comisión Interministerial de Precios de los Medicamentos (Reglamento interno), Comité asesor. Procedimiento de fijación de precio, criterios de evaluación para fijar el precio, procedimiento de actualización de la cartera de servicios comunes, estado de la tramitación. Actividad política a nivel estatal y autonómico. Breve referencia al Parlamento Europeo. La Patente y su ampliación. Conclusiones
Profilaxis Pre Exposición (PrEP) a VIH en España: conocimiento, necesidad y situación político administrativa
(Instituto de Salud Carlos III (ISCIII). Centro Nacional de Epidemiología (CNE), 2018-01-18) Iniesta-Marmol, Carlos; Garcia-Sousa, Luis Miguel
Prevención del VIH. Qué es la PrEP. Conocimiento, uso y necesidad de PrEP en el Orgullo Gay de Madrid, 2017. La prevención del VIH como política pública: la implementación de la PrEP. Métodos, resultados y conclusiones.
Competencias para Medicina Preventiva y Salud Pública: propuestas tras un proceso comparativo y participativo
(Elsevier, 2021) Gonzalez-Rubio, Raquel; Latasa Zamalloa, Pello; Aginagalde Llorente, Adrián Hugo; Peremiquel-Trillas, Paula; Ruiz-Montero, Rafael; Gullen, Pedro; García Diez, Marta; Reques, Laura; Efrain Pantoja Bustillos, Percy; Velasco Muñoz, César; Iniesta-Marmol, Carlos; Aguilera Mellado, José Antonio; Ojeda-Ruiz, Elena; Grupo de Competencias de ARES-MPSP
[ES] Introducción: El desarrollo normativo de la Ley 44/2003, a través del Real Decreto 639/2014, inició el proceso de reorganización de la Formación Sanitaria Especializada (FSE). El objetivo de este trabajo es elaborar una propuesta de competencias específicas para la especialidad de Medicina Preventiva y Salud Pública mediante un análisis comparado y proceso participativo. Métodos: Cuatro fases: 1) análisis y extracción de competencias de documentación de organismos oficiales; 2) consulta dirigida a personas clave; 3) consulta abierta a residentes y personas implicadas en la FSE, y 4) difusión a la Comisión Nacional de la Especialidad y público general. Resultados: 1) Se extrajeron 543 competencias y 67 categorías de 7 fuentes primarias (Austria, Canadá, ECDC, Estados Unidos, Francia, Reino Unido y OPS). Se produjeron 126 competencias en 12 categorías. 2) Participaron 10 personas clave, 64 competencias fueron modificadas, 10 eliminadas y 9 nuevas. 3) Hubo 32 respuestas: 132 competencias en 12 categorías. Propuesta final: 145 competencias en 21 categorías, organizadas en 3 bloques: competencias genéricas, técnicas y específicas. Conclusión: La propuesta final es producto de la participación de residentes y personas implicadas en la FSE, partiendo del actual marco y del análisis del desarrollo de la especialidad en el contexto internacional. Se han incorporado conceptos presentes en países de nuestro entorno y cercanos a la práctica. [EN] Introduction: The Royal Decree 639/2014 (‘Core Curriculum’ Decree) has amongst its objectives to modify Specialist Training in Medicine Disciplines. The aim of this project is to elaborate a proposal of specific skills for the specialty of Preventive Medicine and Public Health using a comparative and participative approach. Methods: 1) Comparative analysis of documents published by official institutions; 2) consultation with key informants; 3) open consultation with residents and trainers, and 4) presentation to the National Commission of the Specialty and the general public. Results: 1) 126 competencies were found in 12 categories. 2) 10 key informants, 64 skills modified, 10 removed, and 9 added; 3) 32 responses the first draft contained 132 skills in 12 categories. The final proposal included 145 skills in 21 categories, classified into 3 areas: generic, technical, and specific skills. Conclusion: The final proposal is the product of participation of residents and individuals involved in specialised training, starting from the current framework and international context analysis. Concepts present in countries in this field and close to our professional activity have been included.
Tipping the balance towards long-term retention in the HIV care cascade: A mixed methods study in southern Mozambique
(Public Library of Science (PLOS), 2019) Fuente-Soro, Laura; Iniesta-Marmol, Carlos; López-Varela, Elisa; Cuna, Mauro; Guilaze, Rui; Maixenchs, Maria; Bernardo, Edson Luis; Augusto, Orvalho; Gonzalez, Raquel; Couto, Aleny; Munguambe, Khatia; Naniche, Denise
BACKGROUND: The implementation of quality HIV control programs is crucial for the achievement of the UNAIDS 90-90-90 targets and to motivate people living with HIV (PLWHIV) to link and remain in HIV-care. The aim of this mixed method cross-sectional study was to estimate the linkage and long-term retention in care of PLWHIV and to identify factors potentially interfering along the HIV-care continuum in southern Mozambique. METHODS: A home-based semi-structured interview was conducted in 2015 to explore barriers and facilitators to the HIV-care cascade among individuals that had been newly HIV-diagnosed in community testing campaigns in 2010 or 2012. Linkage and long-term retention were estimated retrospectively through client self-reports and clinical records. Cohen's Kappa coefficient was calculated to measure the agreement between participant self-reported and documented cascade outcomes. RESULTS: Among the 112 interviewed participants, 24 (21.4%) did not disclose their HIV-positive serostatus to the interviewer. While 84 (75.0%) self-reported having enrolled in care, only 69 (61.6%) reported still being in-care 3-5 years after diagnosis of which 17.4% reported having disengaged and re-engaged. An important factor affecting optimal continuum in HIV-care was the impact of the fear-based authoritarian relationship between the health system and the patient that could act as both driver and barrier. CONCLUSION: Special attention should be given to quantify and understand repeated cycles of patient disengagement and re-engagement in HIV-care. Strategies to improve the relationship between the health system and patients are still needed in order to optimally engage PLWHIV for long-term periods.
Aproximación a las causas de ingreso de las personas trans a través del conjunto mínimo básico de datos en España durante el periodo 2001 a 2013.
(Ministerio de Sanidad y Consumo (España), 2019) Latasa Zamalloa, Pello; Velasco Muñoz, César; Iniesta-Marmol, Carlos; de Beltrán Gutierrez, Paula; Curto Ramos, Javier; Gil-Borrelli, Christian-Carlo
OBJECTIVE: The health of transgender people is a little studied topic and hospital records can be an opportunity to make an approach. The aim of this study was to describe the cause for admission and the associated comorbidities of transgender people in Spain between 2001 and 2013. METHODS: Retrospective observational study with population-based administrative records (Minimum Basic Data Set). The discharges generated by the transgender in Spanish public and private hospitals were selected using one of the following ICD-9-CM codes in any diagnostic field: Trans-sexualism (302.5), Disorders of psychosexual identity (302.6) and Gender identity disorder in adolescents or adults (302.85). The causes of admission and comorbidity according were described. The qualitative variables were described in their frequency distribution according to their number(n) and proportion(%) and the quantitative variables according to their mean and standard deviation (SD) or median (MD) and interquartile range (RIQ) according to their distribution. RESULTS: A total of 2,010 highs were recorded corresponding to 1,878 patients. The mean age was 33 years (SD = 10). 51% were male, 46% female and 3% undetermined or unspecified. The discharges were motivated in 59% by the process of body modification, followed by HIV (4%) and personality disorders (3%). The most common comorbidities were those associated with body modification (49%), mental health problems (40%) and infectious diseases (15%). CONCLUSIONS: It is necessary to address the health of transgender people in a comprehensive way that takes into account their specific health needs, including bodily modification, mental health, HIV and other infections, through strategies that include improve research, tailor health information systems and develop guidelines and training of healthcare providers in this transgender health.
Would eligible gay, bisexual and other men who have sex with men use PrEP? Awareness, knowledge, eligibility and intention to use PrEP among EMIS-2017 participants in Spain
(Elsevier, 2022-03) Iniesta-Marmol, Carlos; Folch, Cinta; Meyer, Sebastian; Vázquez, María; Casabona, Jordi; Diaz Franco, Asuncion; Consumers, Health, Agriculture and Food Executive Agency
Pre-exposure prophylaxis (PrEP) is an efficacious strategy for reducing the incidence of HIV infection. It has been available in Spain since 2019. We aim to report on awareness, knowledge of, intention to use, and eligibility for PrEP and related factors among participants in the European Men-Who-Have-Sex-With-Men Internet Survey (EMIS-2017) in Spain. We used Spanish data from EMIS-2017, a cross-sectional study performed among gay, bisexual, and other men who have sex with mean (GBMSM) from 50 countries. We found that 65.3% of the 10,634 participants were aware of PrEP, some 30.1% of those HIV-negative and ≥ 18 years were eligible and 52.7% of those eligible intended to use it. Regarding knowledge about PrEP, only 15.4% of the participants knew 3 statement with true information about that PrEP meant. Older age, being born in Western Europe (WE) and greater outness were associated with greater awareness. Older age, being born in Latin America or Caribbean or WE, sex work, and living in a large city were associated with greater eligibility. A greater degree of outness was associated with reduced intention to use. Our study point to possible barriers in the implementation of PrEP in Spain and similar countries.
Awareness, knowledge, use, willingness to use and need of Pre-Exposure Prophylaxis (PrEP) during World Gay Pride 2017
(Public Library of Science (PLOS), 2018) Iniesta-Marmol, Carlos; Alvarez-del Arco, Debora; Garcia-Sousa, Luis Miguel; Alejos, Belén; Diaz Franco, Asuncion; Sanz, Nieves; Garrido, Jorge; Meulbroek, Michael; Pujol, Ferran; Moreno, Santiago; Fuster-Ruiz de Apodaca, María José; Coll, Pep; Antela, Antonio; Del Romero, Jorge; Ayerdi, Oskar; Riera, Melchor; Hernández, Juanse; Amo, Julia del; Red de Investigación Cooperativa en Investigación en Sida (España)
OBJECTIVE: To assess the awareness, knowledge, use, and willingness to use and need of PrEP among men who have sex with men (MSM) and transgender women (TW) who attended World Gay Pride (WGP) 2017 in Madrid. DESIGN AND METHODS: Online survey. Participants were recruited through gay-oriented dating apps and HIV Non-Governmental Organizations´ social media. Inclusion criteria included being MSM or TW, age 18 years old or above, and having attended WGP in Madrid. Information regarding the participant's awareness and knowledge, use or willingness to use, and need for PrEP was collected, as well as sociodemographic characteristics. Participants were considered to be in need of PrEP if they met one of the following indication criteria: having practiced unprotected anal intercourse with more than 2 partners, having practiced chemsex, or having engaged in commercial sex-all in the preceding 6 months. Descriptive and multivariable analyses with logistic regression were conducted. RESULTS: 472 participants met the inclusion criteria and completed the questionnaire. The mean age was 38, 97.7% were MSM, 77% had a university education, and 85% were living in Spain, mostly in big cities. Overall, 64% of participants were aware of PrEP, but only 33% knew correctly what PrEP was. 67% of HIV-negative participants were willing to take PrEP, although only 5% were taking it during WGP, mostly due to lack of access. 43% of HIV-negative respondents met at least one PrEP indication criteria. For HIV-negative men living in Spain, university education and living in big cities was associated with PrEP awareness. Lower education level and meeting PrEP criteria was associated with willingness to use PrEP. CONCLUSIONS: Our study shows that among MSM attending WGP 2017 in Madrid, there was limited PrEP awareness, low accuracy of PrEP knowledge, and a high need and willingness to use PrEP. Health authorities should strengthen existing preventive strategies and implement PrEP.
Implementation of pre-exposure prophylaxis programme in Spain. Feasibility of four different delivery models.
(Public Library of Science (PLOS), 2021) Iniesta-Marmol, Carlos; Coll, Pep; Barbera, Maria Jesus; García Deltoro, Miguel; Camino, Xabier; Fagúndez, Gabriela; Diaz Franco, Asuncion; Polo, Rosa; National AIDS Programme; Ministerio de Sanidad (España)
Pre-exposure prophylaxis (PrEP) is an effective and cost-effective strategy for HIV prevention. Spain carried out an implementation study in order to assess the feasibility of implementing PrEP programmes within its heterogeneous health system. Observational longitudinal study conducted on four different types of health-care setting: a community centre (CC), a sexually transmitted infections clinic (STIC), a hospital-based HIV unit (HBHIVU) and a hospital-based STI unit (HBSTIU). We recruited gay, bisexual and other men who have sex with men (GBSM) and transgender women at risk of HIV infections, gave them PrEP and monitored clinical, behavioural PrEP-related and satisfaction information for 52 weeks. We collected perceptions on PrEP implementation feasibility from health-care professionals participating in the study. A total of 321 participants were recruited, with 99.1% being GBMSM. Overall retention was 87.2% and it was highest at the CC (92.6%). Condom use decreased during the study period, while STIs did not increase consistently. The percentage of people who did not miss any doses of PrEP during the previous week remained at over 93%. No HIV seroconversions occurred. We observed overall decreases in GHB (32.5% to 21.8%), cocaine (27.5% to 21.4%), MDMA (25.7% to 14.3%), speed (11.4% to 5.7%) and mephedrone use (10.7% to 5.0%). The overall participant satisfaction with PrEP was 98.6%. Health-care professionals' perceptions of PrEP feasibility were positive, except for the lack of personnel. PrEP implementation is feasible in four types of health-care settings. Local specificities have to be taken into consideration while implementing PrEP.
Terapias de conversión en España: entre la LGTB-fobia y la iatrogenia
(Elsevier, 2019) Gil-Borrelli, Christian-Carlo; Obón, Blanca; Velasco, César; de Beltrán, Paula; Ruiz-Álvarez, Miguel; Iniesta-Marmol, Carlos; Curto, Javier; Sánchez, Héctor; Latasa, Pello
Prevalence and patterns of illicit drug use in people living with HIV in Spain: A cross-sectional study
(Public Library of Science (PLOS), 2019) Fuster-RuizdeApodaca, Maria Jose; Castro-Granell, Vanessa; Garin, Noé; Laguía, Ana; Jaén, Ángeles; Iniesta-Marmol, Carlos; Cenoz, Santiago; Galindo, María J
This study assessed the prevalence and patterns of drug use among people living with HIV (PLHIV) in Spain. We conducted an observational cross-sectional study including 1401 PLHIV. Data were collected through 33 sites across Spain using an online computer-assisted self-administered interview. The survey measured use of illicit drugs and other substances, treatment adherence and health-related variables. To analyse patterns of drug use we performed cluster analysis in two stages. The most frequently consumed substances were: alcohol (86.7%), tobacco (55.0%), illicit drugs (49.5%), other substances (27.1%). The most prevalent illicit drugs used were cannabis (73.8%), cocaine powder (53.9%), and poppers (45.4%). Results found four clusters of PLHIV who used drugs. Two of them were composed mainly of heterosexuals (HTX): Cluster 1 (n = 172) presented the lowest polydrug use and they were mainly users of cannabis, and Cluster 2 (n = 84) grouped mostly men who used mainly heroin and cocaine; which had the highest percentage of people who inject drugs and presented the lowest level of treatment adherence (79.8±14.2; p < .0001). The other two clusters were composed mainly of men who have sex with men (MSM), who were mostly users of recreational drugs. Cluster 3 (n = 285) reported moderate consumption, both regarding frequency and diversity of drugs used, while Cluster 4 (n = 153) was characterized by the highest drug polyconsumption (7.4±2.2; p < .0001), and 4 grouped MSM who injected recreational drugs, and who reported the highest frequency of use of drugs in a sexual context (2.6±0.8; p < .0001) and rates of sexually transmitted infections (1.8±1.1; p < .01). This is the largest multi-centre cross-sectional study assessing the current prevalence and patterns of drug use among PLHIV in Spain. The highest prevalence of drug use was found among MSM, although HTX who used heroin and cocaine (Cluster 2) had the most problems with adherence to HIV treatment and the worst health status.