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High levels of postmigration HIV acquisition within nine European countries

Alvarez-Del Arco, D; Fakoya, I; Thomadakis, C; Pantazis, N; Touloumi, G; Gennotte, A-F; Zuure, F; ... aMASE (Advancing Migrant Access to Health Services in Europe), ; + view all (2017) High levels of postmigration HIV acquisition within nine European countries. AIDS , 31 (14) pp. 1979-1988. 10.1097/QAD.0000000000001571. Green open access

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Abstract

OBJECTIVE: We aimed to estimate the proportion of post-migration HIV acquisition among HIV-positive migrants in Europe. DESIGN: To reach HIV positive migrants we designed a cross sectional study performed in HIV clinics. METHODS: The study was conducted from July 2013-July 2015 in 57 clinics (9 European countries, targeting individuals over 18 years diagnosed in the preceding 5 years and born abroad. Electronic questionnaires supplemented with clinical data were completed in any of 15 languages. Post-migration HIV acquisition was estimated through Bayesian approaches combining extensive information on migration and patients' characteristics. CD4 counts and HIV-RNA trajectories from seroconversion were estimated by bivariate linear mixed models fitted to natural history data. Post-migration acquisition risk factors were investigated with weighted logistic regression. RESULTS: Of 2009 participants, 46% were men who have sex with men (MSM) and a third originated from Sub-Saharan Africa (SSA) and Latin America & Caribbean (LAC), respectively. Median time in host countries was 8 years. Post-migration HIV acquisition was 63% (95% CI: 57%-67%); 72% among MSM, 58% and 51% in heterosexual men and women, respectively. Post-migration HIV acquisition was 71% for LAC migrants and 45% for people from SSA. Factors associated with post-migration HIV acquisition among heterosexual women and MSM were age at migration, length of stay in host country and HIV diagnosis year and among heterosexual men, length of stay in host country, and HIV diagnosis year. CONCLUSIONS: A substantial proportion of HIV-positive migrants living in Europe acquired HIV post-migration. This has important implications for European public health policies.

Type: Article
Title: High levels of postmigration HIV acquisition within nine European countries
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/QAD.0000000000001571
Publisher version: http://doi.org/10.1097/QAD.0000000000001571
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: HIV; Transients and Migrants; Europe
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/1562223
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