HIV disease among immigrants coming to Italy from outside of the European Union: a case-control study of epidemiological and clinical features

Abstract

The epidemiological, clinical and therapeutic features of HIV disease diagnosed in 41 immigrants from outside of the European Union (EU), were compared with those of 123 Italian and EU patients, in a cross-sectional case-control study, with individuals matched according to age and gender. In total 4.15% of our patients came from outside of the EU (51.2% of them from subsaharan Africa), with a proportional predominance of females, and heterosexual and perinatal transmission of HIV disease (P < 0.0001 and P < 0.02, respectively). Compared with Italian and EU subjects, patients coming from abroad had a shorter duration of known HIV infection (P < 0.001), but only some subjects were aware of their HIV disease prior to immigration, or acquired HIV infection only after coming to Italy (14.6% and 12.2%, respectively). No cases of HIV-2 infection or co-infection were detected in either study group. Compared with controls, patients coming from outside of the EU had a comparable clinical and immunological status, and had similar antiretroviral therapy, which was administered earlier (P < 0.0001), and proved better tolerated (P < 0.04), than in Italian and EU subjects. The apparently more limited virological response (as expressed by a higher mean plasma viral load, and a lower rate of viral suppression at the last visit; P < 0.001 and P < 0.05, respectively), was probably a bias due to the shorter mean overall follow-up time (P < 0.0001), and the shorter mean duration of antiretroviral treatment (11.1 +/- 2.2 months of immigrants vs. 16.2 +/- 6.7 months of controls; P < 0.0001).

Migrants from Sub-Saharan Africa in the Swiss HIV Cohort Study: A Single Center Study of Epidemiologic Migration-Specific and Clinical Features

“…Various other European countries are facing equal challenges. [7][8][9][10] In the case of the study from The Netherlands 9 and the United Kingdom 10 the source of infection (in the country of origin or in the host country) and sexual mixing patterns among different ethnic groups were analyzed. In the Amsterdam study half of the migrants who had come to The Netherlands more than 5 years ago had visited their country of origin during the past 5 years.…”

Social, Behavioural, and Intervention Research among People of Sub-Saharan African Origin Living with HIV in the UK and Europe: Literature Review and Recommendations for Intervention

“…Throughout Western Europe, people of sub-Saharan African origin tend to present at a more advanced stage of disease, resulting in poorer prognosis (Del Amo, Bröring, & Fenton, 2003;Manfredi, Calza, & Chiodo, 2001;Staehelin et al, 2003). An unlinked and anonymous seroprevalence survey undertaken among heterosexual attendees at seven genitourinary medicine clinics in London between 1999 and 2000 found that 1 in 16 women and 1 in 33 men born in sub-Saharan Africa were infected with HIV.…”

HIV vulnerability and sexual risk among African youth in Windsor, Canada

“…Of special interest is the increase in risk and vulnerability of members of minority ethnic groups to HIV and other sexually transmitted infections (STIs) (Venema et al 1995, McMunn et al 1998, Remis et al 1998, Manfredi et al 2001, Rosenthal et al 2003. Global data suggest that two-thirds of all people newly infected with HIV are between the ages of 15 and 24 and that about 6,000 young people contract HIV every day (UNAIDS 2004 2004a, 2004b).…”