Knowledge shaped by practice.

Analyses PrEP discontinuation and its structural and demographic determinants in a diverse cohort of sex workers receiving care at a specialist clinic in Madrid.

Impact: Among 189 participants, the incidence of discontinuation was 9.9 per 100 person-months, reaching 20.8 among cisgender women, and housing instability almost doubled the adjusted risk of discontinuation (aHR 1.91).

Estimates HIV and HCV prevalence and risk factors and characterises their care cascades through integrated, low-threshold screening at locations with high levels of vulnerability in Madrid.

Impact: Among 4,582 people, prevalence was 6.3% for HIV and 5.5% for active HCV; 17.0% of people with a known HIV diagnosis were not receiving treatment, and 16.8% of those with HCV antibodies did not complete confirmatory RNA testing.

Follows the everyday experiences, adherence, facilitators and barriers over three months among cisgender and transgender women engaged in sex work who started daily oral PrEP in Madrid.

Impact: Fifteen participants contributed 1,266 daily surveys and 13 interviews; mean adherence exceeded 70%, with routines and alarms identified as facilitators, and adverse effects, travel and rigid protocols as barriers.

Estimates the prevalence, trends and risk factors for active HCV infection among at-risk migrants screened at social and harm reduction centres in Madrid between 2019 and 2023.

Impact: Among 2,288 migrants, the prevalence of active infection was 3.1%, and 57 of 70 people with a positive RNA result started treatment; current injecting drug use increased the adjusted rate 14.7-fold.

Characterises Latin American asylum seekers living with HIV and the barriers they face in continuing treatment and accessing healthcare in Madrid.

Impact: Among 631 participants, 74% faced healthcare barriers and 33% arrived with a detectable viral load; after six months, 99% were taking treatment and 98% had an undetectable viral load.

Assesses risk factors and trends in active HCV infection between 2017 and 2023 among people who use drugs seen by a mobile screening unit in Madrid.

Impact: Among 2,264 participants, active infection fell from 23.4% to 6.0% overall, from 41.0% to 15.0% among people who injected drugs and from 7.0% to 1.3% among those who did not inject.

Examines the intention to use PrEP and the determinants of inconsistent condom use among cisgender women engaged in sex work contacted through NGO outreach activities in Madrid.

Impact: Among 102 participants, only 9.8% knew about PrEP, but 72.5% intended to use it, and 25.5% reported inconsistent condom use, indicating a clear gap in information and access.

A 2019-2023 study estimating the prevalence, risk factors and trends in active HCV infection among people experiencing homelessness screened on the streets and in shelters in Madrid.

Impact: Among 2,709 people experiencing homelessness, there were 172 active infections and 148 treatment initiations, while prevalence fell from 7.2% to 3.4% between 2019 and 2023.

Compares rapid HCV, HIV and HBV tests using capillary blood in community settings with conventional laboratory assays in a vulnerable population in Madrid.

Impact: Among 301 participants, the tests achieved 98.8% sensitivity and 100% specificity for HCV and 100% for both measures for HIV; the clinical estimate for HBV was limited by having only four confirmed positive cases.

Evaluates the acceptance of combining COVID-19 vaccination with HCV screening and, in Madrid, HIV screening too, among marginalised populations receiving care in Barcelona and from a mobile unit in Madrid.

Impact: All 101 participants at the Madrid mobile unit accepted vaccination and screening; 9 were HCV RNA-positive and 8 started treatment, while 3 of 5 people with HIV who had discontinued therapy restarted it.

Evaluates a model of HIV care integrated with addiction care and observed administration of antiretroviral treatment among people who used drugs.

Impact: The model achieved viral suppression of 73% in the intention-to-treat analysis and 92.4% in the modified analysis, associated with opioid substitution treatment and adherence above 90%.

Analyses differences in the HCV care cascade and time to treatment across several vulnerable subpopulations screened with a mobile unit between 2019 and 2021.

Impact: Of 214 people with active infection, 164 started treatment and 141 completed it; people who injected drugs were less likely to start treatment and, along with those with alcohol use disorder, were less likely to complete treatment.

Quantifies severe injection-related infections and hospital admissions among people who inject drugs receiving opioid agonist treatment through a mobile service without a supervised consumption room.

Impact: Among 237 participants, 104 severe episodes were recorded in 56 people, an incidence of 26.8 per 100 person-years, and 53.8% of episodes ended in patient-directed discharge.

Investigates whether reading a rapid HCV antibody test at five minutes maintains the ability to identify people with viraemia and speeds up screening.

Impact: The five-minute threshold identified all viraemic cases in the Madrid group of 176 people with antibodies and achieved 100% sensitivity and negative predictive value in the combined cohorts.

Describes HIV screening, retention in care and linkage to HCV care among people who use drugs receiving care in Cañada Real Galiana.

Impact: Of 529 participants, 35 had HIV, and retention fell from 28 people at the end of screening in 2018 to 22 at the end of 2020; of 12 people with active HCV coinfection, only 5 started treatment.

Evaluates a simplified model that diagnoses active HCV infection in a single visit to the mobile unit and accompanies people with positive results to hospital on the same day.

Impact: Of 2,001 participants, 136 had active infection; 134 received their result, 133 obtained an appointment, 126 were seen by a doctor and 105 started treatment.

Evaluates HCV screening using dried blood spots and describes the subsequent care cascade, while also estimating HBV and HDV prevalence, among people who use drugs reached by a mobile unit.

Impact: Of 529 participants, 122 were HCV RNA-positive, but only 62 were assessed in hospital and 56 started treatment, showing that diagnosis worked better than linkage to care.

A review that identifies HCV infection as a significant cause of chronic liver disease and outlines the remaining challenges to its eradication.

Impact: Provides strategic context on HCV elimination, but the excerpt does not present a cohort or original results from the Mobile Unit.

Describes violence, abuse and other gender-related vulnerabilities among women who used heroin or cocaine and were seen during infection screening at a harm reduction service in Madrid.

Impact: Of 109 women, 88% reported emotional or psychological harm, 71% serious physical injuries caused by a male partner and 49% sexual abuse, supporting multidisciplinary interventions with a gender perspective.

Measures early HCV reinfection after antiviral treatment among people with recent drug use seen at two low-threshold mobile harm reduction units.

Impact: There were 10 reinfections among 121 people at risk: 9.8 per 100 person-years overall and 18.9 per 100 person-years among those who had injected in the 30 days before treatment.

Estimates HIV incidence among people who use drugs followed at a harm reduction unit and assesses the need to add PrEP to prevention strategies.

Impact: Ten of 260 participants with follow-up seroconverted: 3.02 cases per 100 person-years overall and 4.98 among those with HCV, whose infection was associated with a 6.43-fold higher adjusted risk.

Develops and evaluates a method for detecting HCV and HIV from the same capillary dried blood spot sample in real-world practice.

Impact: In 139 samples, HIV serology achieved 100% across all metrics, HCV serology achieved 92.6% sensitivity and 100% specificity, and HCV RNA detection achieved 99.1% sensitivity and 100% specificity.