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BMC Public Health
Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

A systematic review of post-migration acquisition of HIV among migrants from countries with generalised HIV epidemics living in Europe: mplications for effectively managing HIV prevention programmes and policy

Authors: Ibidun Fakoya, Débora Álvarez-del Arco, Melvina Woode-Owusu, Susana Monge, Yaiza Rivero-Montesdeoca, Valerie Delpech, Brian Rice, Teymur Noori, Anastasia Pharris, Andrew J. Amato-Gauci, Julia del Amo, Fiona M. Burns

Published in: BMC Public Health | Issue 1/2015

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Abstract

Background

Migrant populations from countries with generalised HIV epidemics make up a significant proportion of all HIV/AIDS cases in many European Union and European Economic Area (EU/EEA) countries, with heterosexual transmission the predominant mode of HIV acquisition. While most of these infections are diagnosed for the first time in Europe, acquisition is believed to have predominantly occurred in the home country. A proportion of HIV transmission is believed to be occurring post-migration, and many countries may underestimate the degree to which this is occurring. Our objectives were to review the literature estimating the proportion of migrants believed to have acquired their HIV post-migration and examine which EU member states are able to provide estimates of probable country of HIV acquisition through current surveillance systems.

Methods

A systematic review was undertaken to gather evidence of sexual transmission of HIV within Europe among populations from countries with a generalised epidemic. In addition, national surveillance focal points from 30 EU/EEA Member States were asked to complete a questionnaire about surveillance methods and monitoring of the likely place of HIV acquisition among migrants.

Results & discussion

Twenty-seven papers from seven countries were included in the review and 24 countries responded to the survey. Estimates of HIV acquisition post-migration ranged from as low as 2 % among sub Saharan Africans in Switzerland, to 62 % among black Caribbean men who have sex with men (MSM) in the UK. Surveillance methods for monitoring post-migration acquisition varied across the region; a range of methods are used to estimate country or region of HIV acquisition, including behavioural and clinical markers. There is little published evidence addressing this issue, although Member States highlight the importance of migrant populations in their epidemics.

Conclusions

There is post-migration HIV acquisition among migrants in European countries but this is difficult to quantify accurately with current data. Migrant MSM appear at particular risk of HIV acquisition post-migration. Countries that identify migrants as an important part of their HIV epidemic should focus on using an objective method for assigning probable country of HIV acquisition. Robust methods to measure HIV incidence should be considered in order to inform national prevention programming and resource allocation.
Footnotes
1
The search was updated on 9th January 2015 to include articles published between January 2012 and December 2014.
 
2
These are EU/EFTA countries: Austria; Belgium; Bulgaria; Cyprus; Czech Republic; Denmark; Estonia; Finland; France; Germany; Greece; Hungary; Iceland; Republic of Ireland; Italy; Latvia; Liechtenstein; Lithuania; Luxembourg; Malta; The Netherlands; Norway; Poland; Portugal; Romania; Slovakia; Switzerland; Slovenia; Spain; Sweden; UK.
 
3
European Centre for Disease Prevention and Control. Thematic report: Migrants. Monitoring implementation of the Dublin Declaration on partnership to fight HIV/AIDS in Europe and Central Asia: 2012 Progress Report. Stockholm: ECDC; 2013.
 
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Metadata
Title
A systematic review of post-migration acquisition of HIV among migrants from countries with generalised HIV epidemics living in Europe: mplications for effectively managing HIV prevention programmes and policy
Authors
Ibidun Fakoya
Débora Álvarez-del Arco
Melvina Woode-Owusu
Susana Monge
Yaiza Rivero-Montesdeoca
Valerie Delpech
Brian Rice
Teymur Noori
Anastasia Pharris
Andrew J. Amato-Gauci
Julia del Amo
Fiona M. Burns
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-1852-9

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