High levels of postmigration HIV acquisition within nine European countries

作者：Débora Álvarez-del Arco, Ibidun Fakoya, Christos Thomadakis, Nikos Pantazis, Giota Touloumi, Anne-Françoise Gennotte, Freke Zuure, Henrique Barros, Cornelia Staehelin, Siri Göpel, Christoph Boesecke, Tullio Prestileo, Alain Volny‐Anne, Fiona Burns, Julia del Amo · 发表于：AIDS · 年份：2017 · DOI：10.1097/qad.0000000000001571 · 被引用次数：149 · 研究领域：HIV/AIDS Research and Interventions、HIV Research and Treatment、Migration, Health and Trauma

OBJECTIVE: We aimed to estimate the proportion of postmigration 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 to July 2015 in 57 clinics (nine 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. Postmigration HIV acquisition was estimated through Bayesian approaches combining extensive information on migration and patients' characteristics. CD4 cell counts and HIV-RNA trajectories from seroconversion were estimated by bivariate linear mixed models fitted to natural history data. Postmigration acquisition risk factors were investigated with weighted logistic regression. RESULTS: Of 2009 participants, 46% were MSM and a third originated from sub-Saharan Africa and Latin America & Caribbean, respectively. Median time in host countries was 8 years. Postmigration HIV acquisition was 63% (95% confidence interval: 57-67%); 72% among MSM, 58 and 51% in heterosexual men and women, respectively. Postmigration HIV acquisition was 71% for Latin America and Caribbean migrants and 45% for people from sub-Saharan Africa. Factors associated with postmigration HIV acquisition among heterosexual women and MSM were age at migration, length of stay in host country and HIV diagnosis year a...