High levels of postmigration HIV acquisition within nine European countries

Debora Alvarez-Del Arco, Ibidun Fakoya, Christos Thomadakis, Nikos Pantazis, Giota Touloumi, Anne Francoise Gennotte, Freke Zuure, Henrique Barros, Cornelia Staehelin, Siri Göpel, Christoph Boesecke, Tullio Prestileo, Alain Volny-Anne, Fiona Burns, Julia Del Amo, A. Aerssens, M. Aguado, B. Alimi, D. Álvarez-Del Arco, O. AnagnostouJ. Anderson, A. Antoniadou, M. Arando, M. J. Barberà, H. Barros, A. Barthélemy, J. Belda-Ibáñez, B. Bertisch, J. Bil, J. R. Blanco, K. Block, C. Boesecke, M. Boura, J. Burgos, F. M. Burns, J. Cabo, E. Calabuig, L. Campbell, O. Cardoso, W. Claudia, N. Clumeck, A. Colucci, S. Corrao, S. Cuellar, J. Cunha, G. Daikos, K. Darling, J. Del Amo, J. Del Romero, S. Taylor, Advancing Migrant Access to Health Services in Europe (aMASE) study team

Research output: Contribution to journalArticlepeer-review

78 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)1979-1988
Number of pages10
Issue number14
StatePublished - Sep 10 2017


  • Europe
  • HIV
  • transients and migrants

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases


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