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

Author

Fakoya, Ibidun, Arco, Débora Álvarez?Del, Monge, Susana, Copas, Andrew J., Gennotte, Anne?Francoise, Volny?Anne, Alain, Wengenroth, Claudia, Touloumi, Giota, Prins, Maria, Barros, Henrique, Darling, Katharine Ea, Prestileo, Tullio, Del Amo, Julia, Burns, Fiona M., Aerssens, A, Aguado, M, Alimi, B, Anagnostou, O, Anderson, J, Antoniadou, A, Arando, M, Barberà, Mj, Barthélemy, A, Belda?Ibáñez, J, Bertisch, B, Bil, J, Blanco, Jr, 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, Romero, J, Dellot, P, Domingo, P, Dronda, F, Ebeling, F, Engelhardt, A, Engler, B, Farrell, J, Fehr, J, Feijó, M, Fernández, E, García, E Fernández, Fernandez, T, Fortes, Al, Fox, J, De Olalla, P Garcia, García, F, Gargalianos?Kakolyris, P, Germano, I, Gilleran, G, Gilson, R, Goepel, S, Gogos, Ha, Sirvent, Jl Gómez, Gountas, I, Gregg, A, Gutiérrez, F, Gutierrez, Mm, Hermans, I, Iribarren, Ja, Knobel, H, Koulai, L, Kourkounti, S, La Morté, C, Lecompte, T, Ledergerber, B, Leonidou, L, Ligero, Mc, Lindergard, G, Lino, S, Lopes, Mj, Lirola, A Lopez, Louhenapessy, M, Lourida, G, Luzi, Am, Maltez, F, Manirankunda, L, Martín?Pérez, A, Martins, L, Masía, M, Mateu, Mg, Meireles, P, Mendes, A, Metallidis, S, Mguni, S, Milinkovic, A, Miró, Jm, Mohrmann, K, Montero, M, Mouhebati, T, Moutschen, M, Müller, M, Murphy, C, Nöstlinger, C, Ocaña, I, Okumu?Fransche, S, Onwuchekwa, G, Ospina, Je, 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, Jk, Rodrigues, E, Rodríguez, M, Sajani, C, Salavert, M, Salman, R, Sanz, N, Schuettfort, G, Schüttfort, G, Zander, C Schwarze?, Serrão, R, Silva, D, Silva, V, Silverio, P, Skoutelis, A, Staehelin, C, Stephan, C, Stretton, C, Styles, F, Sutre, Af, Taylor, S, Teixeira, B, Thierfelder, C, Tsachouridou, O, Tudor, K, Valadas, E, Frankenhuijsen, M, Vázquez, M, Arribas, M Velasco, Vera, M, Vinciana, P, Voudouri, N, Wasmuth, Jc, Wilkins, E, Young, L, Yurdakul, S, Espinosa, T Zafra, Zuilhof, W, and Zuure, F

Subjects
HIV testing -- Surveys, Immigrants -- Surveys -- Care and treatment, HIV infection -- Surveys -- Diagnosis -- Care and treatment, Health
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 Conclusions: 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., Introduction The HIV epidemic in Europe is characterized by a disproportionate number of infections among migrants. Although foreign citizens only made up 7% of the population of the European Union [...]

Published
2018
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2. Validation of a Novel Multivariate Method of Defining HIV-Associated Cognitive Impairment

Author

Underwood, Jonathan, De Francesco, Davide, Cole, James H, Caan, Matthan W A, van Zoest, Rosan A, Schmand, Ben A, Sharp, David J, Sabin, Caroline A, Reiss, Peter, Winston, Alan Coolaboratori: Reiss P, Wit FWNM, Schouten J, Kooij KW, van Zoest RA, Elsenga BC, Janssen FR, Heidenrijk M, Zikkenheiner W, van der Valk M, Kootstra NA, Harskamp-Holwerda AM, Maurer I, Mangas Ruiz MM, Girigorie AF, Villaudy J, Frankin E, Pasternak A, Berkhout B, van der Kuyl T, Portegies P, Schmand BA, Geurtsen GJ, Ter Stege JA, Klein Twennaar M, Majoie CBLM, Caan MWA, Su T, Weijer K, Bisschop PHLT, Kalsbeek A, Wezel M, Visser I, Ruhé HG, Franceschi C, Garagnani P, Pirazzini C, Capri M, Dall'Olio F, Chiricolo M, Salvioli S, Hoeijmakers J, Pothof J, Prins M, Martens M, Moll S, Berkel J, Totté M, Kovalev S, Gisslén M, Fuchs D, Zetterberg H, Winston A, Underwood J, McDonald L, Stott M, Legg K, Lovell A, Erlwein O, Doyle N, Kingsley C, Sharp DJ, Leech R, Cole JH, Zaheri S, Hillebregt MMJ, Ruijs YMC, Benschop DP, Burger D, de Graaff-Teulen M, Guaraldi G, Bürkle A, Sindlinger T, Moreno-Villanueva M, Keller A, Sabin C, de Francesco D, Libert C, Dewaele S, Boffito M, Mallon P, Post F, Sachikonye M, Anderson J, Asboe D, Garvey L, Pozniak A, Vera J, Williams I, Campbell L, Yurdakul S, Okumu S, Pollard L, Otiko D, Phillips L, Laverick R, Fisher M, Clarke A, Bexley A, Richardson C, Macken A, Ghavani-Kia B, Maher J, Byrne M, Flaherty A, Mguni S, Clark R, Nevin-Dolan R, Pelluri S, Johnson M, Ngwu N, Hemat N, Jones M, Carroll A, Whitehouse A, Burgess L, Babalis D, Higgs C, Seah E, Fletcher S, Anthonipillai M, Moyes A, Deats K, Syed I, Matthews C., Underwood, Jonathan, De Francesco, Davide, Cole, James H, Caan, Matthan W A, van Zoest, Rosan A, Schmand, Ben A, Sharp, David J, Sabin, Caroline A, Reiss, Peter, Winston, Alan Coolaboratori: Reiss P, Wit FWNM, Schouten J, Kooij KW, van Zoest RA, Elsenga BC, Janssen FR, Heidenrijk M, Zikkenheiner W, van der Valk M, Kootstra NA, Harskamp-Holwerda AM, Maurer I, Mangas Ruiz MM, Girigorie AF, Villaudy J, Frankin E, Pasternak A, Berkhout B, van der Kuyl T, Portegies P, Schmand BA, Geurtsen GJ, Ter Stege JA, Klein Twennaar M, Majoie CBLM, Caan MWA, Su T, Weijer K, Bisschop PHLT, Kalsbeek A, Wezel M, Visser I, Ruhé HG, Franceschi C, Garagnani P, Pirazzini C, Capri M, Dall'Olio F, Chiricolo M, Salvioli S, Hoeijmakers J, Pothof J, Prins M, Martens M, Moll S, Berkel J, Totté M, Kovalev S, Gisslén M, Fuchs D, Zetterberg H, Winston A, Underwood J, McDonald L, Stott M, Legg K, Lovell A, Erlwein O, Doyle N, Kingsley C, Sharp DJ, Leech R, Cole JH, Zaheri S, Hillebregt MMJ, Ruijs YMC, Benschop DP, Burger D, de Graaff-Teulen M, Guaraldi G, Bürkle A, Sindlinger T, Moreno-Villanueva M, Keller A, Sabin C, de Francesco D, Libert C, Dewaele S, Boffito M, Mallon P, Post F, Sabin C, Sachikonye M, Winston A, Anderson J, Asboe D, Boffito M, Garvey L, Mallon P, Post F, Pozniak A, Sabin C, Sachikonye M, Vera J, Williams I, Winston A, Post F, Campbell L, Yurdakul S, Okumu S, Pollard L, Williams I, Otiko D, Phillips L, Laverick R, Fisher M, Clarke A, Vera J, Bexley A, Richardson C, Mallon P, Macken A, Ghavani-Kia B, Maher J, Byrne M, Flaherty A, Anderson J, Mguni S, Clark R, Nevin-Dolan R, Pelluri S, Johnson M, Ngwu N, Hemat N, Jones M, Carroll A, Whitehouse A, Burgess L, Babalis D, Winston A, Garvey L, Underwood J, Stott M, McDonald L, Boffito M, Asboe D, Pozniak A, Higgs C, Seah E, Fletcher S, Anthonipillai M, Moyes A, Deats K, Syed I, Matthews C., Molecular Genetics, Biomedical Engineering and Physics, Radiology and Nuclear Medicine, ACS - Atherosclerosis & ischemic syndromes, ACS - Diabetes & metabolism, ACS - Microcirculation, AMS - Restoration & Development, Amsterdam Neuroscience - Brain Imaging, Amsterdam Neuroscience - Neurovascular Disorders, Graduate School, AII - Infectious diseases, APH - Aging & Later Life, Medical Psychology, Amsterdam Neuroscience - Neurodegeneration, Global Health, Infectious diseases, APH - Mental Health, APH - Methodology, Commission of the European Communities, Imperial College Healthcare NHS Trust- BRC Funding, and National Institute for Health Research

Subjects
Multivariate statistics, medicine.medical_specialty, COmorBidity in Relation to AIDS (COBRA) Collaboration and the Pharmacokinetic and clinical Observations in PePle over fiftY (POPPY) Study Group, Immunology, Human immunodeficiency virus (HIV), Audiology, medicine.disease_cause, Microbiology, 03 medical and health sciences, 0302 clinical medicine, multivariate, SDG 3 - Good Health and Well-being, Neuroimaging, Medicine and Health Sciences, medicine, Major Article, OLDER-PEOPLE, 030212 general & internal medicine, VALIDITY, Cognitive impairment, cognitive impairment, Science & Technology, neuroimaging, SCORES, business.industry, Biology and Life Sciences, HIV, MEN, Cognition, Mental health, White matter microstructure, PREVALENCE, 3. Good health, Infectious Diseases, Oncology, REGISTRATION, business, Life Sciences & Biomedicine, Neurocognitive, 030217 neurology & neurosurgery
Abstract

Background The optimum method of defining cognitive impairment in virally suppressed people living with HIV is unknown. We evaluated the relationships between cognitive impairment, including using a novel multivariate method (NMM), patient– reported outcome measures (PROMs), and neuroimaging markers of brain structure across 3 cohorts. Methods Differences in the prevalence of cognitive impairment, PROMs, and neuroimaging data from the COBRA, CHARTER, and POPPY cohorts (total n = 908) were determined between HIV-positive participants with and without cognitive impairment defined using the HIV-associated neurocognitive disorders (HAND), global deficit score (GDS), and NMM criteria. Results The prevalence of cognitive impairment varied by up to 27% between methods used to define impairment (eg, 48% for HAND vs 21% for NMM in the CHARTER study). Associations between objective cognitive impairment and subjective cognitive complaints generally were weak. Physical and mental health summary scores (SF-36) were lowest for NMM-defined impairment (P < .05). There were no differences in brain volumes or cortical thickness between participants with and without cognitive impairment defined using the HAND and GDS measures. In contrast, those identified with cognitive impairment by the NMM had reduced mean cortical thickness in both hemispheres (P < .05), as well as smaller brain volumes (P < .01). The associations with measures of white matter microstructure and brain-predicted age generally were weaker. Conclusion Different methods of defining cognitive impairment identify different people with varying symptomatology and measures of brain injury. Overall, NMM-defined impairment was associated with most neuroimaging abnormalities and poorer self-reported health status. This may be due to the statistical advantage of using a multivariate approach., We have previously described a novel multivariate method (NMM) with theoretical statistical advantages over existing methods, which we assessed here in 3 cohorts of people living with HIV. Overall, NMM-defined impairment was associated with most neuroimaging abnormalities and poorer self-reported health status.

Published
2019

3. Validation of a Novel Multivariate Method of Defining HIV-Associated Cognitive Impairment

Author

Underwood, J, de Francesco, D, Cole, JH, Caan, MWA, van Zoest, RA, Schmand, BA, Sharp, DJ, Sabin, CA, Reiss, P, Winston, A, Wit, FWNM, Schouten, J, Kooij, KW, Elsenga, BC, Janssen, FR, Heidenrijk, M, Zikkenheiner, W, van der Valk, M, Kootstra, NA, Harskamp-Holwerda, AM, Maurer, I, Ruiz, MMM, Girigorie, AF, Villaudy, J, Frankin, E, Pasternak, A, Berkhout, B, van der Kuyl, T, Portegies, P, Geurtsen, GJ, ter Stege, JA, Twennaar, MK, Majoie, CBLM, Su, T, Weijer, K, Bisschop, PHLT, Kalsbeek, A, Wezel, M, Visser, I, Ruhe, HG, Franceschi, C, Garagnani, P, Pirazzini, C, Capri, M, Dall'Olio, F, Chiricolo, M, Salvioli, S, Hoeijmakers, J, Pothof, J, Prins, M, Martens, M, Moll, S, Berkel, J, Totte, M, Kovalev, S, Gisslen, M, Fuchs, D, Zetterberg, H, McDonald, L, Stott, M, Legg, K, Lovell, A, Erlwein, O, Doyle, N, Kingsley, C, Leech, R, Zaheri, S, Hillebregt, MMJ, Ruijs, YMC, Benschop, DP, Burger, D, de Graaff-Teulen, M, Guaraldi, G, Buerkle, A, Sindlinger, T, Moreno-Villanueva, M, Keller, A, Sabin, C, Libert, C, Dewaele, S, Boffito, M, Mallon, P, Post, F, Sachikonye, M, Anderson, J, Asboe, D, Garvey, L, Pozniak, A, Vera, J, Williams, I, Campbell, L, Yurdakul, S, Okumu, S, Pollard, L, Otiko, D, Phillips, L, Laverick, R, Fisher, M, Clarke, A, Bexley, A, Richardson, C, Macken, A, Ghavani-Kia, B, Maher, J, Byrne, M, Flaherty, A, Mguni, S, Clark, R, Nevin-Dolan, R, Pelluri, S, Johnson, M, Ngwu, N, Hemat, N, Jones, M, Carroll, A, Whitehouse, A, Burgess, L, Babalis, D, Higgs, C, Seah, E, Fletcher, S, Anthonipillai, M, Moyes, A, Deats, K, Syed, I, Matthews, C, Underwood, J, de Francesco, D, Cole, JH, Caan, MWA, van Zoest, RA, Schmand, BA, Sharp, DJ, Sabin, CA, Reiss, P, Winston, A, Wit, FWNM, Schouten, J, Kooij, KW, Elsenga, BC, Janssen, FR, Heidenrijk, M, Zikkenheiner, W, van der Valk, M, Kootstra, NA, Harskamp-Holwerda, AM, Maurer, I, Ruiz, MMM, Girigorie, AF, Villaudy, J, Frankin, E, Pasternak, A, Berkhout, B, van der Kuyl, T, Portegies, P, Geurtsen, GJ, ter Stege, JA, Twennaar, MK, Majoie, CBLM, Su, T, Weijer, K, Bisschop, PHLT, Kalsbeek, A, Wezel, M, Visser, I, Ruhe, HG, Franceschi, C, Garagnani, P, Pirazzini, C, Capri, M, Dall'Olio, F, Chiricolo, M, Salvioli, S, Hoeijmakers, J, Pothof, J, Prins, M, Martens, M, Moll, S, Berkel, J, Totte, M, Kovalev, S, Gisslen, M, Fuchs, D, Zetterberg, H, McDonald, L, Stott, M, Legg, K, Lovell, A, Erlwein, O, Doyle, N, Kingsley, C, Leech, R, Zaheri, S, Hillebregt, MMJ, Ruijs, YMC, Benschop, DP, Burger, D, de Graaff-Teulen, M, Guaraldi, G, Buerkle, A, Sindlinger, T, Moreno-Villanueva, M, Keller, A, Sabin, C, Libert, C, Dewaele, S, Boffito, M, Mallon, P, Post, F, Sachikonye, M, Anderson, J, Asboe, D, Garvey, L, Pozniak, A, Vera, J, Williams, I, Campbell, L, Yurdakul, S, Okumu, S, Pollard, L, Otiko, D, Phillips, L, Laverick, R, Fisher, M, Clarke, A, Bexley, A, Richardson, C, Macken, A, Ghavani-Kia, B, Maher, J, Byrne, M, Flaherty, A, Mguni, S, Clark, R, Nevin-Dolan, R, Pelluri, S, Johnson, M, Ngwu, N, Hemat, N, Jones, M, Carroll, A, Whitehouse, A, Burgess, L, Babalis, D, Higgs, C, Seah, E, Fletcher, S, Anthonipillai, M, Moyes, A, Deats, K, Syed, I, and Matthews, C

Abstract

BACKGROUND: The optimum method of defining cognitive impairment in virally suppressed people living with HIV is unknown. We evaluated the relationships between cognitive impairment, including using a novel multivariate method (NMM), patient- reported outcome measures (PROMs), and neuroimaging markers of brain structure across 3 cohorts. METHODS: Differences in the prevalence of cognitive impairment, PROMs, and neuroimaging data from the COBRA, CHARTER, and POPPY cohorts (total n = 908) were determined between HIV-positive participants with and without cognitive impairment defined using the HIV-associated neurocognitive disorders (HAND), global deficit score (GDS), and NMM criteria. RESULTS: The prevalence of cognitive impairment varied by up to 27% between methods used to define impairment (eg, 48% for HAND vs 21% for NMM in the CHARTER study). Associations between objective cognitive impairment and subjective cognitive complaints generally were weak. Physical and mental health summary scores (SF-36) were lowest for NMM-defined impairment ( P < .05).There were no differences in brain volumes or cortical thickness between participants with and without cognitive impairment defined using the HAND and GDS measures. In contrast, those identified with cognitive impairment by the NMM had reduced mean cortical thickness in both hemispheres ( P < .05), as well as smaller brain volumes ( P < .01). The associations with measures of white matter microstructure and brain-predicted age generally were weaker. CONCLUSION: Different methods of defining cognitive impairment identify different people with varying symptomatology and measures of brain injury. Overall, NMM-defined impairment was associated with most neuroimaging abnormalities and poorer self-reported health status. This may be due to the statistical advantage of using a multivariate approach.

Published
2019

4. 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

5. 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

6. 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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