HIV testing history and access to treatment among migrants living with HIV in Europe.

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State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_27551DA114DE
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
HIV testing history and access to treatment among migrants living with HIV in Europe.
Journal
Journal of the International AIDS Society
Author(s)
Fakoya I., Álvarez-Del Arco D., Monge S., Copas A.J., Gennotte A.F., Volny-Anne A., Wengenroth C., Touloumi G., Prins M., Barros H., Darling K.E., Prestileo T., Del Amo J., Burns F.M.
Working group(s)
aMASE Study Team
Contributor(s)
Aerssens A., Aguado M., Alimi B., Anagnostou O., Anderson J., Antoniadou A., Arando M., Barberà M.J., Barthélemy A., Belda-Ibáñez J., Bertisch B., Bil J., Blanco J.R., Block K., Boesecke C., Boura M., Burgos J., Cabo J., Calabuig E., Campbell L., Cardoso O., Claudia W., Clumeck N., Colucci A., Corrao S., Cuellar S., Cunha J., Daikos G., Darling K., Del Romero J., Dellot P., Domingo P., Dronda F., Ebeling F., Engelhardt A., Engler B., Farrell J., Fehr J., Feijó M., Fernández E., Fernández García E., Fernandez T., Fortes A.L., Fox J., Garcia de Olalla P., García F., Gargalianos-Kakolyris P., Germano I., Gilleran G., Gilson R., Goepel S., Gogos H.A., Gómez Sirvent J.L., Gountas I., Gregg A., Gutiérrez F., Gutierrez M.M., Hermans I., Iribarren J.A., Knobel H., Koulai L., Kourkounti S., La Morté C., LeCompte T., Ledergerber B., Leonidou L., Ligero M.C., Lindergard G., Lino S., Lopes M.J., Lopez Lirola A., Louhenapessy M., Lourida G., Luzi A.M., Maltez F., Manirankunda L., Martín-Pérez A., Martins L., Masía M., Mateu M.G., Meireles P., Mendes A., Metallidis S., Mguni S., Milinkovic A., Miró J.M., Mohrmann K., Montero M., Mouhebati T., Moutschen M., Müller M., Murphy C., Nöstlinger C., Ocaña I., Okumu-Fransche S., Onwuchekwa G., Ospina J.E., Otiko D., Pacheco P., Palacios R., Paparizos V., Papastamopoulos V., Paredes V., Patel N., Pellicer T., Peña A., Petrosillo N., Pinheiro A., Poças J., Portillo A., Post F., Prestileo F., Prins P., Protopapas K., Psichogiou M., Pulido F., Rebollo J., Ribeirinho A., Río I., Robau M., Rockstroh J.K., Rodrigues E., Rodríguez M., Sajani C., Salavert M., Salman R., Sanz N., Schuettfort G., Schüttfort G., Schwarze-Zander C., Serrão R., Silva D., Silva V., Silverio P., Skoutelis A., Staehelin C., Stephan C., Stretton C., Styles F., Sutre A.F., Taylor S., Teixeira B., Thierfelder C., Tsachouridou O., Tudor K., Valadas E., van Frankenhuijsen M., Vázquez M., Velasco Arribas M., Vera M., Vinciana P., Voudouri N., Wasmuth J.C., Wilkins E., Young L., Yurdakul S., Zafra Espinosa T., Zuilhof W., Zuure F.
ISSN
1758-2652 (Electronic)
ISSN-L
1758-2652
Publication state
Published
Issued date
07/2018
Peer-reviewed
Oui
Volume
21 Suppl 4
Pages
e25123
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Migrants are overrepresented in the European HIV epidemic. We aimed to understand the barriers and facilitators to HIV testing and current treatment and healthcare needs of migrants living with HIV in Europe.
A cross-sectional study was conducted in 57 HIV clinics in nine countries (Belgium, Germany, Greece, Italy, The Netherlands, Portugal, Spain, Switzerland and United Kingdom), July 2013 to July 2015. HIV-positive patients were eligible for inclusion if they were as follows: 18 years or older; foreign-born residents and diagnosed within five years of recruitment. Questionnaires were completed electronically in one of 15 languages and linked to clinical records. Primary outcomes were access to primary care and previous negative HIV test. Data were analysed using random effects logistic regression. Outcomes of interest are presented for women, heterosexual men and gay/bisexual men.
A total of 2093 respondents (658 women, 446 heterosexual men and 989 gay/bisexual men) were included. The prevalence of a previous negative HIV test was 46.7%, 43.4% and 82.0% for women, heterosexual and gay/bisexual men respectively. In multivariable analysis previous testing was positively associated with: receipt of post-migration antenatal care among women, permanent residency among heterosexual men and identifying as gay rather than bisexual among gay/bisexual men. Access to primary care was found to be high (>83%) in all groups and was strongly associated with country of residence. Late diagnosis was common for women and heterosexual men (60.8% and 67.1%, respectively) despite utilization of health services prior to diagnosis. Across all groups almost three-quarters of people on antiretrovirals had an HIV viral load <50 copies/mL.
Migrants access healthcare in Europe and while many migrants had previously tested for HIV, that they went on to test positive at a later date suggests that opportunities for HIV prevention are being missed. Expansion of testing beyond sexual health and antenatal settings is still required and testing opportunities should be linked with combination prevention measures such as access to PrEP and treatment as prevention.
Keywords
AIDS Serodiagnosis, Adult, Anti-Retroviral Agents/therapeutic use, Bisexuality, Cross-Sectional Studies, Europe/epidemiology, Female, HIV Infections/diagnosis, HIV Infections/drug therapy, Health Services Accessibility, Heterosexuality, Humans, Logistic Models, Male, Pregnancy, Primary Health Care, Sexual Behavior/statistics & numerical data, Sexual and Gender Minorities, Transients and Migrants, HIV, HIV serodiagnosis, health services accessibility, migrants, primary healthcare
Pubmed
Web of science
Open Access
Yes
Create date
31/07/2018 16:29
Last modification date
14/03/2020 7:26
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