Central and East European migrant men who have sex with men: an exploration of sexual risk in the UK

Evans, Alison; Hart, Graham; Mole, Richard; Mercer, Catherine H; Parutis, Violetta; Gerry, Christopher J.; Imrie, J; Burns, Fiona

doi:10.1136/sti.2010.046409

Cited by 27 publications

(31 citation statements)

References 13 publications

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“…All cases (determinate and indeterminate) : UK acquired: 25.1 % - 35.4 %, Acquired abroad 60.8 % - 67.3 %.SD: +++ V: +++ G: +++ OS: +++Acquisition of HIV in UK negatively associated with late presentation therefore findings may underestimate infection acquired in UK. Sample only includes Africans living in London, therefore may not be representative to all HIV positive Africans in the UK.del Amo et al (2011) [33]Most studies among sub-Saharan African migrants report infections acquired in the country of origin; includes studies in Denmark, Spain, UK & Canada. Some evidence of post-migration HIV acquisition in EU countries (includes Latin American MSM & other migrant populations); evidence of acquisition during return visits to country of origin.SD: +++ V: +++ G: +++ OS: +++The search strategy includes only articles in English; research in other languages, the grey literature and conference abstracts not included.Dougan et al (2005) [39]New diagnosis: probable country of infection reported for 38 % of BME MSM.…”

Section: Resultsmentioning

confidence: 99%

“…Behavioural data suggests assortative sexual mixing according to country of origin or ethnicity is not a prevailing feature of sex between men [33] as reflected in the predominance of B subtypes in these communities [32]. Acquisition of viral clades not prevalent in home countries supports post-migration acquisition and (as with heterosexual men) this highlights the need for primary prevention programs targeting these communities.…”

Section: Discussionmentioning

confidence: 99%

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A systematic review of post-migration acquisition of HIV among migrants from countries with generalised HIV epidemics living in Europe: mplications for effectively managing HIV prevention programmes and policy

et al. 2015

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BackgroundMigrant populations from countries with generalised HIV epidemics make up a significant proportion of all HIV/AIDS cases in many European Union and European Economic Area (EU/EEA) countries, with heterosexual transmission the predominant mode of HIV acquisition. While most of these infections are diagnosed for the first time in Europe, acquisition is believed to have predominantly occurred in the home country. A proportion of HIV transmission is believed to be occurring post-migration, and many countries may underestimate the degree to which this is occurring. Our objectives were to review the literature estimating the proportion of migrants believed to have acquired their HIV post-migration and examine which EU member states are able to provide estimates of probable country of HIV acquisition through current surveillance systems.MethodsA systematic review was undertaken to gather evidence of sexual transmission of HIV within Europe among populations from countries with a generalised epidemic. In addition, national surveillance focal points from 30 EU/EEA Member States were asked to complete a questionnaire about surveillance methods and monitoring of the likely place of HIV acquisition among migrants.Results & discussionTwenty-seven papers from seven countries were included in the review and 24 countries responded to the survey. Estimates of HIV acquisition post-migration ranged from as low as 2 % among sub Saharan Africans in Switzerland, to 62 % among black Caribbean men who have sex with men (MSM) in the UK. Surveillance methods for monitoring post-migration acquisition varied across the region; a range of methods are used to estimate country or region of HIV acquisition, including behavioural and clinical markers. There is little published evidence addressing this issue, although Member States highlight the importance of migrant populations in their epidemics.ConclusionsThere is post-migration HIV acquisition among migrants in European countries but this is difficult to quantify accurately with current data. Migrant MSM appear at particular risk of HIV acquisition post-migration. Countries that identify migrants as an important part of their HIV epidemic should focus on using an objective method for assigning probable country of HIV acquisition. Robust methods to measure HIV incidence should be considered in order to inform national prevention programming and resource allocation.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A systematic review of post-migration acquisition of HIV among migrants from countries with generalised HIV epidemics living in Europe: mplications for effectively managing HIV prevention programmes and policy

et al. 2015

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“…Studies have demonstrated elevated HIV prevalence (EMIS, 2013;Evans et al, 2011) and diagnosis rates (Egan et al, 2011) among migrant MSM. However, we know of no research that directly measures whether incidence of HIV infection is greater among recent urban migrants.…”

Section: Introductionmentioning

confidence: 98%

New Arrivals to New York City: Vulnerability to HIV among Urban Migrant Young Gay Men

2015

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This qualitative study explored the social experiences and HIV-related sexual practices of 30 young gay and bisexual men who moved to New York City in the past 3 years from other countries or elsewhere in the United States. For many migrants, a key basis of vulnerability to HIV was their engagement with New York City's unfamiliar sexual culture. Many recent arrivals migrated from places with small gay communities and low HIV prevalence, and some came with a practice of limited condom use. Participants described encountering an abundance of sexual opportunity in New York City, accessible to even the newest arrivals through internet sex sites. Some migrants expressed surprise that few men they met were interested in dating or establishing trust before having sex. Although frequent HIV testing was common, HIV status, testing history, and condom use were seldom discussed with sex partners for some men even with new partners or before sex without condoms. International and in-country migrants who are beginning to navigate New York City's gay sexual culture may be more vulnerable to HIV infection than established residents if they are inexperienced in encountering vast sexual opportunity, are less practiced in local norms of sexual communication, or if their lack of economic resources or social connections encourages them to have sex for money or shelter. This article suggests HIV prevention interventions for urban migrants and other men who have sex with men.

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“…This study is part of the SALLEE (sexual attitudes and lifestyles of London's Eastern Europeans) project. Papers examining the sexual risk of CEE migrant men who have sex with men5 and CEE migrant attendance at genitourinary medicine clinics and STI diagnoses,6 which arise from this project as well, are also published in this issue of STI.…”

Section: Introductionmentioning

confidence: 99%

Sexual and HIV risk behaviour in Central and Eastern European migrants in London

Burns

Evans

Mercer

et al. 2011

Sexually Transmitted Infections

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Background Accession of 10 Central and Eastern European (CEE) countries to the EU resulted in the largest migratory influx in peacetime British history. No information exists on the sexual behaviour of CEE migrants within the UK. The aim of this study was to assess the sexual lifestyles and health service needs of these communities. Methods A survey, delivered electronically and available in 12 languages, of migrants from the 10 CEE accession countries recruited from community venues in London following extensive social mapping and via the Internet. Reported behaviours were compared with those from national probability survey data. Results 2648 CEE migrants completed the survey. Male CEE migrants reported higher rates of partner acquisition (adjusted OR (aOR) 2.1, 95% CI: 1.3 to 2.1) and paying for sex (aOR 3.2, 95% CI: 2.5 to 4.0), and both male and female CEE migrants reported more injecting drug use (men: aOR 2.2, 95% CI: 1.3 to 3.9; women: aOR 3.0, 95% CI 1.1 to 8.1), than the general population; however, CEE migrants were more likely to report more consistent condom use and lower reported diagnoses of sexually transmitted infections (STI). Just over 1% of respondents reported being HIV positive. Most men and a third of women were not registered for primary care in the UK. Discussion CEE migrants to London report high rates of behaviours associated with increased risk of HIV/STI acquisition and transmission. These results should inform service planning, identify where STI and HIV interventions should be targeted, and provide baseline data to help evaluate the effectiveness of such interventions.

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Central and East European migrant men who have sex with men: an exploration of sexual risk in the UK

Cited by 27 publications

References 13 publications

A systematic review of post-migration acquisition of HIV among migrants from countries with generalised HIV epidemics living in Europe: mplications for effectively managing HIV prevention programmes and policy

A systematic review of post-migration acquisition of HIV among migrants from countries with generalised HIV epidemics living in Europe: mplications for effectively managing HIV prevention programmes and policy

New Arrivals to New York City: Vulnerability to HIV among Urban Migrant Young Gay Men

Sexual and HIV risk behaviour in Central and Eastern European migrants in London

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