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

Author

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.A. Prestileo, T. Del Amo, J. Burns, F.M. 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. the aMASE Study Team

Subjects
virus diseases
Abstract

Introduction: 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. Methods: 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. Results: 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

Published
2018

2. High levels of postmigration HIV acquisition within nine European countries

Author

Alvarez-Del Arco, D. Fakoya, I. Thomadakis, C. Pantazis, N. Touloumi, G. Gennotte, A.-F. Zuure, F. Barros, H. Staehelin, C. Göpel, S. Boesecke, C. Prestileo, T. Volny-Anne, A. Burns, F. Del Amo, J. Aerssens, A. Aguado, M. Alimi, B. Álvarez-Del Arco, D. 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. Burns, F.M. 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 Amo, J. Del Romero, J. Dellot, P. Dixneuf, M. Domingo, P. Dronda, F. Ebeling, F. Engelhardt, A. Engler, B. Fakoya, I. 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. Gennotte, A.F. 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. Monge, S. 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. Prestileo, T. Prins, M. 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. Touloumi, G. Tsachouridou, O. Tudor, K. Valadas, E. Van Frankenhuijsen, M. Vázquez, M. Velasco Arribas, M. Vera, M. Vinciana, P. Volny-Anne, A. Voudouri, N. Wasmuth, J.C. Wengenroth, C. Wilkins, E. Young, L. Yurdakul, S. Zafra Espinosa, T. Zuilhof, W. Zuure, F. Advancing Migrant Access to Health Services in Europe (aMASE) study team

Subjects
virus diseases
Abstract

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 and among heterosexual men, length of stay in host country and HIV diagnosis year. Conclusion: A substantial proportion of HIV-positive migrants living in Europe acquired HIV postmigration. This has important implications for European public health policies. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.

Published
2017

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

Author

Giota Touloumi, Tullio Prestileo, Maria Prins, Ibidun Fakoya, Julia del Amo, Fiona Burns, Andrew Copas, Katharine Ea Darling, Henrique Barros, Anne-Francoise Gennotte, Debora Alvarez-del Arco, Alain Volny-Anne, Claudia Wengenroth, Susana Monge, Unión Europea. Comisión Europea. 7 Programa Marco, National Institute for Health Research (Reino Unido), Fundación para la Investigación y la Prevención del Sida en España, Centro de Investigación Biomedica en Red - CIBER, APH - Global Health, Infectious diseases, aMASE Study Team, 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., and Zuure, F.

Subjects
Male, 0301 basic medicine, Cross-sectional study, HIV Infections, migrants, Logistic regression, Health Services Accessibility, Sexual and Gender Minorities, 0302 clinical medicine, Pregnancy, Health care, Medicine, 030212 general & internal medicine, 10. No inequality, Research Articles, Reproductive health, Transients and Migrants, AIDS Serodiagnosis, virus diseases, 3. Good health, Europe, Infectious Diseases, Anti-Retroviral Agents, behavior and behavior mechanisms, population characteristics, Bisexuality, Female, Viral load, geographic locations, Research Article, Adult, Sexual Behavior, Migrants, primary healthcare, 03 medical and health sciences, Humans, HIV serodiagnosis, ddc:610, Heterosexuality, Anti-Retroviral Agents/therapeutic use, Cross-Sectional Studies, Europe/epidemiology, HIV Infections/diagnosis, HIV Infections/drug therapy, Logistic Models, Primary Health Care, Sexual Behavior/statistics & numerical data, HIV, health services accessibility, business.industry, Health services accessibility, Public Health, Environmental and Occupational Health, social sciences, Treatment as prevention, 030112 virology, Residence, business, Primary healthcare, Demography
Abstract

INTRODUCTION: 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. METHODS: 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. RESULTS: 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

Published
2018

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