What Works? Prevention and Control of Sexually Transmitted Infections and Blood-Borne Viruses in Migrants from Sub-Saharan Africa, Northeast Asia and Southeast Asia Living in High-Income Countries: A Systematic Review

Abstract

Migration is a significant risk factor for the acquisition of human immunodeficiency virus (HIV), hepatitis B virus (HBV) and other sexually transmitted infections (STIs). An increasing proportion of these infections in high-income countries, such as Australia, are among migrants moving from low and middle-income countries with a high prevalence of HIV, HBV and other STIs. This systematic review explored the prevention and control of HIV, HBV and other STIs in migrants (>18 years) from Southeast Asia, Northeast Asia and sub-Saharan Africa living in high-income countries with universal health care. This systematic review followed PRISMA guidelines and was registered with PROSPERO. Six academic databases were searched for articles published between 2002 and 2018. Sixteen peer-reviewed articles met the inclusion criteria, consisting of fourteen quantitative and two qualitative studies conducted in Australia, the Netherlands, Canada, Spain, Italy, and Germany. Three levels of interventions were identified: individual, community and structural interventions. Most studies addressed factors at an individual level; interventions were most commonly outreach testing for HIV, HBV and other STIs. Few studies addressed structural factors or demonstrated comprehensive evaluation of interventions. Limited population-specific findings could be determined. To prevent further transmission of HIV, HBV and other STIs, comprehensive public health approaches must consider the complex interactions between migration, health care system determinants, and broader socioeconomic and sociocultural factors.

Socioecological Factors Influencing Sexual Health Experiences and Health Outcomes of Migrant Asian Women Living in ‘Western’ High-Income Countries: A Systematic Review

“…We recommend the use of conceptual and methodological frameworks such as transnationalism, intersectionality, SEM, and social determinants of health to better explore the intersection between gender, migration, and sexual and reproductive health inequalities. As with previous research [ 26 ], effective sexual health interventions for migrant populations are limited in HICs, an important consideration for those working within health promotion, education, and service delivery. Participatory approaches that build on community strengths are recommended [ 75 , 76 ].…”

“…Whilst many studies recommended sexual health education for migrant women, the SEM suggests interventions focusing on individual health behaviour (such as education) may not be effective on their own given considerable influences on knowledge, attitudes, and behaviour experienced at the interpersonal and societal level. Previous research has demonstrated an absence of reported societal interventions to address STIs amongst migrants [ 26 ]. Women’s health, including their ability to develop sexual health literacy and navigate condom use, is strongly affected by sociocultural factors including social justice, gender equality, and human rights [ 58 , 59 ].…”

“…The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guided this review [ 24 ]. Procedures followed those used in other systematic reviews published by the research team [ 25 , 26 , 27 , 28 ]. The review was registered with the PROSPERO International prospective register of systematic reviews (Registration: CRD42020164726, date: 24 August 2020).…”

HIV Prevention Concepts—Counter Movements Challenging Societies

“…In effect, these people were allowed to continue engaging in risky sexual behavior. iii) Outreach testing depending on the situation (e.g., peculiar situations need analyses for migrants crossing borders) [118].…”

Economic Crisis and Sexually Transmitted Infections: A Comparison Between Native and Immigrant Populations in a Specialised Centre in Granada, Spain

“…Increased migration has contributed to the spread of HIV, Hepatitis B Virus (HBV), and other STIs, with the vast majority of cases occurring in migrants from low-and middle-income countries who have moved to high-income countries. Most interventions in the United States of America, Australia, and Europe focus on individual behaviour rather than on broader sociocultural factors [5].…”