HIV Infection in Migrant Populations in the European Union and European Economic Area in 2007–2012

Hernando, Victoria; Arco, Débora Álvarez-del; Alejos, Belén; Monge, Susana; Amato‐Gauci, Andrew J.; Noori, Teymur; Pharris, Anastasia; Amo, Julia del

doi:10.1097/qai.0000000000000717

Cited by 86 publications

(100 citation statements)

References 18 publications

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“…29 MSM migrants in unwelcoming societies might be particularly vulnerable to structural disadvantage given that they may not possess the political, social, or economic status necessary to access health-promoting resources and affect societal change. 30 However, by modifying the structural contexts surrounding MSM migrants through legislation (e.g., enacting laws that recognize the equality of sexual minorities; enacting legal protections against discrimination based on sexual orientation or immigrant status), countries may ensure more equitable access to health-promotion interventions among MSM migrants. Given that these structural changes can be protracted, these findings suggest that in the meantime, recent migration, especially to and from stigmatizing countries, represents an important window of opportunity during which local public health authorities can deliver HIV prevention resources to curb the spread of the HIV epidemic in the increasingly mobile global population.…”

Section: Discussionmentioning

confidence: 99%

Anti-LGBT and Anti-immigrant Structural Stigma: An Intersectional Analysis of Sexual Minority Men's HIV Risk When Migrating to or Within Europe

Pachankis

Hatzenbuehler

Berg

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Objective Gay, bisexual, and other men who have sex with men (MSM) might be particularly likely to migrate to experience freedoms unavailable in their home countries. Structural stigma (e.g., laws and policies promoting the unequal treatment of oppressed populations) in MSM migrants’ sending and receiving countries represent potential barriers to HIV prevention among this intersectional population. This present study represents the first investigation of structural determinants of HIV risk in a large, geographically-diverse sample of MSM migrants. Design The 2010 European MSM Internet Survey (EMIS) (n=23,371 migrants) was administered across 38 European countries. Methods Structural stigma was assessed using (1) national laws and policies promoting unequal treatment of MSM across 181 countries worldwide and (2) national attitudes against immigrants in the 38 receiving countries. We also assessed linguistic status, time since migrating, and five HIV-prevention outcomes. Results Structural stigma toward sexual minorities (in sending and receiving countries) and toward immigrants (in receiving countries) was associated with a lack of HIV-prevention knowledge, service coverage, and precautionary behaviors among MSM migrants. Linguistic status and time since migrating moderated some associations between structural stigma and lack of HIV prevention. Conclusions Structural stigma toward MSM and immigrants represents a modifiable structural determinant of the global HIV epidemic.

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Section: Discussionmentioning

confidence: 99%

Anti-LGBT and Anti-immigrant Structural Stigma: An Intersectional Analysis of Sexual Minority Men's HIV Risk When Migrating to or Within Europe

Pachankis

Hatzenbuehler

Berg

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

View full text Add to dashboard Cite

show abstract

“…Country of birth is also relevant to analyse both in relation to condom use and HIV testing, since immigrants in general, and immigrant MSM, tend to be over-represented among newly diagnosed cases of HIV, in Sweden15 16 and across Europe 17…”

Section: Introductionmentioning

confidence: 99%

Factors associated with condom use and HIV testing among young men who have sex with men: a cross-sectional survey in a random online sample in Sweden

et al. 2018

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“…In 2014, 13.8% of new HIV diagnoses in EU/EEA Member states were among sub-Saharan African migrants [1]. Since 2005, surveillance data show a decreasing trend of HIV diagnoses among this group [1, 2]. It is unclear how to interpret this trend.…”

Section: Introductionmentioning

confidence: 99%

“…It is unclear how to interpret this trend. Potential explanations refer to a truly decreasing incidence, changes in migration flows or lower uptake of HIV testing as a result of toughening immigration laws and restricted access to health care and social rights [2]. Consequently, surveillance data provide little indications for prevention planning.…”

Section: Introductionmentioning

confidence: 99%

First HIV prevalence estimates of a representative sample of adult sub-Saharan African migrants in a European city. Results of a community-based, cross-sectional study in Antwerp, Belgium

et al. 2017

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IntroductionWhile sub-Saharan African migrants are the second largest group affected by HIV in Europe, sound HIV prevalence estimates based on representative samples of these heterogeneous communities are lacking. Such data are needed to inform prevention and public health policy.MethodsThis community-based, cross-sectional study combined oral fluid HIV testing with an electronic behavioral survey. Adopting a two-stage time location sampling HIV prevalence estimates for a representative sample of adult sub-Saharan African migrants in Antwerp, Belgium were obtained. Sample proportions and estimated adjusted population proportions were calculated for all variables. Univariable and multivariable logistic regression analysis explored factors independently associated with HIV infection.ResultsBetween December 2013 and October 2014, 744 sub-Saharan African migrants were included (37% women). A substantial proportion was socially, legally and economically vulnerable: 21% were probably of undocumented status, 63% had financial problems in the last year and 9% lacked stable housing. Sexual networks were mostly African and crossed national borders, i.e. sexual encounters during travels within Europa and Africa. Concurrency is common, 34% of those in a stable relationship had a partner on the side in the last year. HIV prevalence was 5.9%(95%CI:3.4%-10.1%) among women and 4.2% (95%CI:1.6%-10.6%) among men. Although high lifetime HIV testing was reported at community level (73%), 65.2% (CI95%:32.4%-88.0%) of sub-Saharan African migrants were possibly undiagnosed. Being 45 years or older, unprotected sex when travelling within Europe in the last year, high intentions to use condoms, being unaware of their last sexual partners’ HIV status, recent HIV testing and not having encountered partner violence in the last year were independently associated with HIV infection in multivariable logical regression. In univariable analysis, HIV infection was additionally associated to unemployment.ConclusionsThis is the first HIV prevalence study among adult sub-Saharan African migrants resettling in a European city based on a representative sample. HIV prevalence was high and could potentially increase further due to the high number of people with an undiagnosed HIV infection, social vulnerability, high levels of concurrency and mainly African sexual networks. Given this population’s mobility, an aligned European combination prevention approach addressing these determinants is urgently needed.

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HIV Infection in Migrant Populations in the European Union and European Economic Area in 2007–2012

Cited by 86 publications

References 18 publications

Anti-LGBT and Anti-immigrant Structural Stigma: An Intersectional Analysis of Sexual Minority Men's HIV Risk When Migrating to or Within Europe

Anti-LGBT and Anti-immigrant Structural Stigma: An Intersectional Analysis of Sexual Minority Men's HIV Risk When Migrating to or Within Europe

Factors associated with condom use and HIV testing among young men who have sex with men: a cross-sectional survey in a random online sample in Sweden

First HIV prevalence estimates of a representative sample of adult sub-Saharan African migrants in a European city. Results of a community-based, cross-sectional study in Antwerp, Belgium

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