Abstract
To evaluate the feasibility of HIV screening, offered to newly arrived asylum seekers in the Swiss cantons of Valais (VS) and Vaud (VD) in order to meet the national and international standards for early detection and effective treatment of HIV infections. HIV screening was offered free of charge to every asylum seeker who arrived from June 2015 to November 2016 in VS, and from June to October 2016 in VD. Pregnant women and children <16 were excluded. Written consent was required in VS through multi-language forms, whereas VD required oral consent obtained with the help of interpreters. 807 asylum seekers were offered HIV testing (VS 451, VD 356). Their mean age was 27.6 years, 61.2% were male, 67.4% were single, 60.8% arrived from sub-Saharan Africa. The overall proportion that accepted HIV screening was 72.2% (VS 63.2%, VD 83.7%). Prevalence of HIV infection was 0.87% (two newly and five previously diagnosed persons). Multivariable analysis found that a higher proportion accepted HIV testing among asylum seekers originating from sub-Saharan Africa, men, and those arriving in VD. the acceptance of HIV screening among asylum seekers was high and appeared to respond to a real demand among this vulnerable population, particularly among those coming from high endemic regions. It may help guaranteeing an equitable access to the local health care system. Ways to reach a high testing rate should still be explored, taking available and necessary resources into account.
Highlights
In 2017, 36.9 million people worldwide were living with HIV, 940,000 died of AIDS and 1.8 million were newly infected, including in Europe and Switzerland [1,2,3]
Multivariable analysis found that a higher proportion accepted HIV testing among asylum seekers originating from sub-Saharan Africa, men, and those arriving in VD
The acceptance of HIV screening among asylum seekers was high and appeared to respond to a real demand among this vulnerable population, among those coming from high endemic regions
Summary
In 2017, 36.9 million people worldwide were living with HIV, 940,000 died of AIDS and 1.8 million were newly infected, including in Europe and Switzerland [1,2,3]. The “90–90–90” strategy of the joint United Nations program on HIV/AIDS (UNAIDS) aims to achieve the following goals: “90% of people living with HIV know their status, 90% of people living with HIV who know their status are receiving antiretroviral treatment (ART) and 90% of people on treatment have suppressed viral loads” This would mean healthier patients and potentially the end of the HIV epidemic [4]. In 2015, the Swiss Federal Office of Public Health published guidelines for targeted HIV screening by physicians [8] Besides clinical situations, these guidelines mention epidemiological risks, such as a sub-Saharan African origin, that should motivate HIV testing. Unlike tuberculosis, HIV is rarely part of national screening programs for infectious diseases among migrants arriving in Europe [9]
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