Venezuelan migrants living with HIV in Barcelona : Migration patterns and baseline immunovirological characteristics in a retrospective cohort study

OBJECTIVES: To describe the sociodemographic characteristics, migration patterns and immunovirological outcomes of Venezuelan migrants living with HIV (PLWH) in Barcelona, Spain, and to compare them with other Latin American (LA) migrant PLWH. METHODS: We conducted a retrospective observational cohort study including LA migrant PLWH who attended their first consultation at the HIV Unit of Hospital Clínic de Barcelona between 2000 and 2023. Venezuelan PLWH were compared with other LA migrant PLWH regarding demographics, HIV diagnosis timing, CD4 cell count, viral load, late HIV diagnosis (LHD) and advanced HIV disease (AHD). RESULTS: A total of 493 Venezuelan PLWH were included, representing 16% of LA migrant PLWH in the cohort. Venezuelan PLWH were predominantly men (97%; n = 478). Most first consultations occurred after 2014 (81%; n = 399), peaking in 2018. Half were diagnosed with HIV after arrival in Spain (50%; 224/451), and 73% (328/451) had lived in Spain for less than 3 years. Among ART-naïve individuals, LHD was 38% in 2000-2008 and 53% in 2015-2023, while baseline CD4 counts progressively declined. Immunological outcomes were similar between Venezuelan and other LA migrants, including LHD (50%; n = 98 vs. 51%; n = 622) and AHD (24%; n = 48 vs. 25%; n = 301). However, ART-experienced Venezuelan PLWH showed lower virological suppression rates (67%; n = 191 vs. 72%; n = 1013; p = 0.068). CONCLUSION: Venezuelan PLWH in this Barcelona cohort represent a rapidly growing migrant population shaped by humanitarian displacement and disruption of HIV care. The high proportion of LHD and lower virological suppression among ART-experienced individuals is compatible with continuity-of-care disruptions before migration but do not establish causality.