High levels of postmigration HIV acquisition within nine European countries
High levels of postmigration HIV acquisition within nine European countries
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DOI：
10.1097/qad.0000000000001571
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发表时间：
2017-09-10
期刊：
影响因子：
3.8
通讯作者：
del Amo, Julia
中科院分区：
文献类型：
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作者：
Alvarez-del Arco, Debora;Fakoya, Ibidun;del Amo, Julia
目的：我们的目的是估计在欧洲的艾滋病毒阳性移民中的移民后艾滋病毒感染的比例。设计图：为了达到艾滋病毒阳性移民，我们设计了一个横断面研究进行艾滋病毒clinics.Methods：这项研究是从2013年7月至2015年7月在57个诊所（9个欧洲国家），针对个人超过18岁的诊断，在过去5年和出生在国外。补充有临床数据的电子问卷以15种语言中的任一种完成。通过贝叶斯方法结合关于迁移和患者特征的广泛信息来估计迁移后HIV感染。CD 4+细胞计数和HIV-RNA轨迹从血清转换估计的二元线性混合模型拟合自然历史数据。移民后收购的风险因素进行了调查与加权logistic regression.Results：在2009年的参与者，46%的MSM和三分之一来自撒哈拉以南非洲和拉丁美洲和加勒比地区，分别。在东道国的平均时间为8年。移民后艾滋病毒感染率为63%（95%置信区间：57-67%）;男男性行为者为72%，异性恋男性和女性分别为58%和51%。在拉丁美洲和加勒比移民中，71%的人在移民后感染艾滋病毒，而在撒哈拉以南非洲地区，这一比例为45%。与移民后艾滋病毒收购的异性恋妇女和男男性行为者的年龄在移民，在东道国逗留时间和艾滋病毒诊断年和异性恋男子，在东道国逗留时间和艾滋病毒诊断year.Conclusion：相当大比例的艾滋病毒阳性移民生活在欧洲获得艾滋病毒移民后。这对欧洲公共卫生政策具有重要意义。版权所有（C）2017威科医疗集团All rights reserved.
Objective: We aimed to estimate the proportion of postmigration HIV acquisition among HIV-positive migrants in Europe. Design: To reach HIV-positive migrants, we designed a cross-sectional study performed in HIV clinics.Methods: The study was conducted from July 2013 to July 2015 in 57 clinics (nine European countries), targeting individuals over 18 years diagnosed in the preceding 5 years and born abroad. Electronic questionnaires supplemented with clinical data were completed in any of 15 languages. Postmigration HIV acquisition was estimated through Bayesian approaches combining extensive information on migration and patients' characteristics. CD4+ cell counts and HIV-RNA trajectories from seroconversion were estimated by bivariate linear mixed models fitted to natural history data. Postmigration acquisition risk factors were investigated with weighted logistic regression.Results: Of 2009 participants, 46% were MSM and a third originated from sub-Saharan Africa and Latin America & Caribbean, respectively. Median time in host countries was 8 years. Postmigration HIV acquisition was 63% (95% confidence interval: 57-67%); 72% among MSM, 58 and 51% in heterosexual men and women, respectively. Postmigration HIV acquisition was 71% for Latin America and Caribbean migrants and 45% for people from sub-Saharan Africa. Factors associated with postmigration HIV acquisition among heterosexual women and MSM were age at migration, length of stay in host country and HIV diagnosis year and among heterosexual men, length of stay in host country and HIV diagnosis year.Conclusion: A substantial proportion of HIV-positive migrants living in Europe acquired HIV postmigration. This has important implications for European public health policies. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.