AIDS

   Since the AIDS epidemic hit Spain in 1981 it is estimated that there may have been as many as 40,000 cases. The National AIDS Register had recorded 27,500 cases to the end of 1994 and 15,000 AIDS-related deaths, but this is generally admitted to be below the real figure, for until the redefinition of AIDS-induced illnesses many conditions and deaths were not attributed to AIDS. The most frequent cause of transmission of the virus is the intravenous use of drugs (64 percent), followed by homosexual relations (15 percent), heterosexual relations (13 percent) and foetal infection (2 percent), a pattern different from that of the rest of Europe, where homosexuality is the chief cause of transmission. Of those known to have been infected 80 percent have been male. It is officially estimated that there are some 150,000 people who are HIVpositive (0.375 percent of the population), and the incidence of AIDS is currently running at something over 4,000 new cases per annum, the worst affected areas by far being Madrid, Catalonia and the Basque country. The strong drugs connection has resulted in 30 percent of the prison population either being HIV-positive or already having developed AIDS. Although the PSOE government led by Felipe González carried out campaigns warning drug users of the dangers of infection through shared needles and urging the use of condoms as a preventive measure, this latter advice was strongly contested by the Catholic Church. The annual cost to the Spanish health service of dealing with the epidemic was running at 20,000m pesetas in 1990 and, according to some Spanish scientists, was leading to the neglect of other important diseases. Meanwhile AIDS has continued to spread, albeit rather more slowly in the 1990s, suggesting greater public awareness of the risks. Nevertheless at a rate of about 120 new diagnosed sufferers per million inhabitants Spain now has the highest incidence of AIDS in Europe.

   C. A. LONGHURST