Time Spent Abroad Predicts Late Presentation for HIV among HIV-positive Tajikistani Migrants to the Russian Federation

Abstract

Background Between 700 thousand and 1.2 million citizens of Tajikistan currently live in the Russian Federation, one of the only countries where the HIV epidemic continues to worsen. Given the previously reported barriers to healthcare access for migrants to the Russian Federation, and the rapidly expanding HIV epidemic in Eastern Europe and Central Asia, this present study set out to determine whether these barriers impact late presentation with HIV among Tajik migrants upon their return to Tajikistan.Results Compared to non-migrants, HIV-positive migrants are more likely to be from Gorno-Badakhshan region, are less likely to use illicit drugs, are more likely to have purchased the services of sex workers, and have more sexual partners on average. The unadjusted logistic model found that for every year spent in the Russian Federation, the risk of late presentation for an HIV-positive Tajikistani migrant increases by 4.0% (95% CI: 0.3-7.7). The multivariate model showed that when age, sex, and region of origin are held constant, the risk of late presentation for an HIV-positive Tajikistani migrant increases by 4.0% (95% CI: 0.1-7.8) for each year spent in the Russian Federation. Conclusion The results of this paper suggest that if the Russian Federation were loosen its restrictions of HIV care for foreign nationals, it might improve the treatment outcomes of migrant laborers. Further research is needed to explicate the causal pathways of the associations found in the present analysis.