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Post-migration acquisition of HIV: Estimates from four European countries, 2007 to 2016
- Zheng Yin1 , Alison E Brown1 , Brian D Rice2 , Gaetano Marrone3 , Anders Sönnerborg3 , Barbara Suligoi4 , Andre Sasse5 , Dominique Van Beckhoven5 , Teymur Noori6 , Vincenza Regine4 , Valerie C Delpech1
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View Affiliations Hide AffiliationsAffiliations: 1 HIV and STI Department, CIDSC, Public Health England, Colindale, London, United Kingdom 2 Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom 3 Department of Infectious Diseases, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden 4 National AIDS Unit, Department of Infectious Diseases, National Institute of Health, Rome, Italy 5 Scientific Institute of Public Health, Brussels, Belgium 6 European Centre for Disease Prevention and Control, Stockholm, SwedenAlison E Brownalison.brown phe.gov.uk
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Citation style for this article: Yin Zheng, Brown Alison E, Rice Brian D, Marrone Gaetano, Sönnerborg Anders, Suligoi Barbara, Sasse Andre, Van Beckhoven Dominique, Noori Teymur, Regine Vincenza, Delpech Valerie C. Post-migration acquisition of HIV: Estimates from four European countries, 2007 to 2016. Euro Surveill. 2021;26(33):pii=2000161. https://doi.org/10.2807/1560-7917.ES.2021.26.33.2000161 Received: 19 Feb 2020; Accepted: 06 Oct 2020
Abstract
The assumption that migrants acquire human immunodeficiency virus (HIV) before migration, particularly those from high prevalence areas, is common.
We assessed the place of HIV acquisition of migrants diagnosed in four European countries using surveillance data.
Using CD4+ T-cell count trajectories modelled to account for seroconversion bias, we estimated infection year of newly HIV-diagnosed migrants residing in the United Kingdom (UK), Belgium, Sweden and Italy with a known arrival year and CD4+ T-cell count at diagnosis. Multivariate analyses identified predictors for post-migration acquisition.
Between 2007 and 2016, migrants constituted 56% of people newly diagnosed with HIV in the UK, 62% in Belgium, 72% in Sweden and 29% in Italy. Of 23,595 migrants included, 60% were born in Africa and 70% acquired HIV heterosexually. An estimated 9,400 migrants (40%; interquartile range (IQR): 34–59) probably acquired HIV post-migration. This proportion was similar by risk group, sex and region of birth. Time since migration was a strong predictor of post-migration HIV acquisition: 91% (IQR: 87–95) among those arriving 10 or more years prior to diagnosis; 30% (IQR: 21–37) among those 1–5 years prior. Younger age at arrival was a predictor: 15–18 years (81%; IQR: 74–86), 19–25 years (53%; IQR: 45–63), 26–35 years (37%; IQR: 30–46) and 36 years and older (25%; IQR: 21–33).
Migrants, regardless of origin, sex and exposure to HIV are at risk of acquiring HIV post-migration to Europe. Alongside accessible HIV testing, prevention activities must target migrant communities.

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