Abstract
This study aimed to examine risky sexual behavior, its associated factors and HIV infection among immigrants. A participatory cross-sectional survey was conducted with 1187 immigrants at the National Immigrant Support Centre, in Lisbon (52.2% female; 34.0% Africans, 33.8% Brazilians, 32.2% Eastern Europeans). About 38% of participants reported ≥2 sexual partners in the previous year, 16.2% both regular and occasional sexual partners (last 12 months), 33.1% inconsistent condom use with occasional partners, and 64% no condom use in the last sexual intercourse. Unprotected sex in the last sexual intercourse was more likely among women, Africans, those older, with elementary education, those married and those who didn’t receive free condoms in the previous year. No condom use was less likely among those having only occasional sexual partners and both regular and occasional sexual partners. One third of participants had never been tested for HIV. Those never tested reported more frequently inconsistent condom use than those ever tested. Overall, 2.0% reported being HIV positive (2.5% of men; 4.4% of Africans); 4.3% admitted having a STI in previous year. HIV-positive immigrants reported high-risk sexual behaviors. Tailored interventions to promote awareness of HIV serostatus among immigrants as well as culturally adapted risk reduction strategies should be strengthened.
Highlights
The HIV epidemic continues to be a major public health concern in the European Union [1,2].Increased international migration, from highly endemic countries, has been acknowledged as one of the major factors influencing the epidemiology of HIV in Europe and contributing to the changing pattern of HIV transmission in this region, where in the recent years sexually transmitted cases have been on the rise [3]
From highly endemic countries, has been acknowledged as one of the major factors influencing the epidemiology of HIV in Europe and contributing to the changing pattern of HIV transmission in this region, where in the recent years sexually transmitted cases have been on the rise [3]
Infection include the long periods away from family and partners, the associated need to seek companionship to compensate for the alienating aspects of the migration experience and the fewer social controls on behavior [9,10], and the experience of social exclusion and lack of legal protection that often translate in lesser means of protection and poorer health status [7,9], and barriers to health services [3,11,12,13]
Summary
The HIV epidemic continues to be a major public health concern in the European Union [1,2].Increased international migration, from highly endemic countries, has been acknowledged as one of the major factors influencing the epidemiology of HIV in Europe and contributing to the changing pattern of HIV transmission in this region, where in the recent years sexually transmitted cases have been on the rise [3]. Previous research indicate that a considerable amount of immigrants report to have multiple partners and to not use condom consistently with both occasional (casual partner with no committed relationship) and regular (main, stable partner) partners [6,7,8,9], which renders this population at risk for HIV infection. Explanations of the increased vulnerability of immigrants to HIV infection include the long periods away from family and partners, the associated need to seek companionship to compensate for the alienating aspects of the migration experience and the fewer social controls on behavior [9,10], and the experience of social exclusion and lack of legal protection that often translate in lesser means of protection and poorer health status [7,9], and barriers to health services (related to their legal status, socioeconomic conditions, language and cultural difference) [3,11,12,13]
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