Changes in patterns of migration barely influence the heterosexual HIV epidemic in Europe
Presented by Maria Xiridou (Netherlands).
M. Xiridou1, M. van Veen1, R. Coutinho1,2, M. Donoghoe3, M. Prins2,4
1National Institute of Public Health and Environment, Bilthoven, Netherlands, 2Academic Medical Center of the University of Amsterdam, Amsterdam, Netherlands, 3WHO Regional Office for Europe, Copenhagen, Denmark, 4Public Health Service of Amsterdam, Amsterdam, Netherlands
Background: Among migrants who originate from countries with generalized HIV epidemics and reside in Europe, the prevalence of HIV has been found to be higher compared to the general population in their country of residence. This study investigates the contribution of migrants to HIV incidence and the impact of demographic changes among migrants to the heterosexual HIV epidemic in Europe.
Methods: A mathematical model is developed for the transmission of HIV in heterosexual partnerships between African migrants, Caribbean migrants, and the local Dutch population. The model is parameterised using data from the Netherlands. Infection of migrants before migrating to the Netherlands and while visiting their home country is also accounted for.
Results: From the model the HIV incidence among heterosexuals in the Netherlands in 2010 is estimated at 2.13 new infections per 100,000 persons per year. The incidence per 100,000 persons of each specific ethnic group residing in the Netherlands is 85.62 among African migrants, 21.86 among Caribbean migrants, and 0.62 among Dutch natives. Among new infections occurring via sexual contacts in the Netherlands, the infection is acquired from a migrant in 72% of the cases, while the partner getting infected is a migrant in 81% of the cases. Waves of migration from countries with higher HIV prevalence, increased number of migrants, and shorter duration of stay in the Netherlands result in higher incidence in the migrant communities, but hardly affect the incidence in the local Dutch population.
Conclusions: The results indicate that the heterosexual transmission of HIV in the Netherlands is mainly contained in migrant communities. This supports other evidence that limiting migration and imposing travel restrictions would likely have no effect on HIV incidence in countries with low HIV prevalence among heterosexuals. Policy making should focus on targeted interventions, to reduce the burden of disease in migrant communities in Europe.
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