{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T03:35:47Z","timestamp":1793504147834,"version":"4.5.0"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T00:00:00Z","timestamp":1739923200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T00:00:00Z","timestamp":1739923200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Health Serv Res"],"abstract":"<jats:title>Summary<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>The burden of opportunistic infections (OIs) remains high among people living with HIV (PLWH) in Mexico, despite improvements in mortality worldwide.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>Reporting the current access to diagnostics of OIs in Mexican Health Care Centers offering health-care services to PLWH.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>An online questionnaire was sent to public health care facilities providing HIV care in Mexico. We evaluated capacities to 1) identify individuals with advanced-HIV, and 2) local and\/or on-site access to: point-of-care assays, imaging studies, histological analysis, and microbiology tests useful to diagnose a wide variety of OIs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>In 2022, 46 centers answered the questionnaire, from 23\/32 (71.8%) states of the country; 29 (63%) were primary care facilities, 5 (11%) general hospitals and 12 (26%) tertiary care hospitals, providing health services to 67,000 PLWH. These centers received 1,135 new patients\/month, 48% with advance disease. Less than 50% could determine CD4\u2009+\u2009T cell count (39%, <jats:italic>N<\/jats:italic>\u2009=\u200918), toxoplasma serology (41%, <jats:italic>N<\/jats:italic>\u2009=\u200919) and HIV viral load (41%, <jats:italic>N<\/jats:italic>\u2009=\u200919). Twenty-five centers could diagnose cryptococcosis and tuberculosis (54%). Meanwhile, 11 centers (24%) had access to aspergillosis or <jats:italic>Histoplasma<\/jats:italic> tests. Seven centers (11%) had access to coccidioidomycosis tests, five centers to any <jats:italic>Pneumocystis<\/jats:italic> diagnosis. In primary care centers, <jats:italic>Mycobacterium tuberculosis<\/jats:italic> complex GeneXPert was accessible in 41%, cryptococcal antigen by latex agglutination was available in one facility (3%), Indian ink in 9 centers (31%). No primary health center had access to lateral flow test for <jats:italic>Cryptococcus<\/jats:italic> or <jats:italic>Histoplasma<\/jats:italic> antigens.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>In Mexico, most public HIV-dedicated health care centers lack on-site capacity to diagnose opportunistic infections, specifically fungal infections. Rapid tests and point-of-care tests are frequently unavailable, which is more pronounced in primary care centres. Considering that IFDs still contribute significantly to mortality among PLWH, better access to diagnostic tools in all levels of HIV-care is urgent.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12913-025-12405-5","type":"journal-article","created":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T02:43:47Z","timestamp":1739933027000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Access to diagnostic testing for invasive fungal diseases and other opportunistic infections in Mexican health care centers caring for patients living with HIV"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4012-1045","authenticated-orcid":false,"given":"Dora E.","family":"Corzo-Leon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7569-8365","authenticated-orcid":false,"given":"Nancy","family":"Martinez-Rivera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8627-404X","authenticated-orcid":false,"given":"Alexandra","family":"Martin-Onraet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9037-617X","authenticated-orcid":false,"given":"Alicia","family":"Pi\u00f1eirua-Menendez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,19]]},"reference":[{"key":"12405_CR1","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1186\/s12879-017-2254-7","volume":"17","author":"O Eyawo","year":"2017","unstructured":"Eyawo O, et al. 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This is a research below minimal risk so according to local regulations set by the Reglamento de la Ley General de Salud en Materia de Investigaci\u00f3n para la Salud published by the Mexican Ministry of Health, ethical approval and informed consent were waived. Participants were not patients; they were representatives of public health care centers. Every representative answering to our survey invitation accepted to participate by fulfilling the online questionnaire. All answers are confidential.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"DECL and AMO do not have any conflict of interest to report for this manuscript. AP currently holds grants for Investigator-Initiated Research as Principal Investigator from ViiV Healthcare and Gilead Sciences.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"275"}}