Abstract
BackgroundMigrants from high endemic countries accounted for 18% of newly diagnosed HIV infections in Europe in 2017. Knowledge on the link between HIV risk and post-migration travels and their impact on HIV acquisition is scarce, but critical to inform prevention. This study aims to explore risky sexual behaviour and HIV-acquisition among sub-Saharan African migrants, and to assess post-migration mobility as a determinant of sexual risk behaviour.MethodsData from two cross-sectional bio-behavioural surveys to assess HIV-prevalence conducted in Lisbon and Antwerp were analysed to explore migration-related characteristics, travel patterns, and sexual risk taking in the host country and abroad. Bi- and multivariate associations were estimated through adjusted odds ratios and 95% confidence intervals; multivariable logistic regression determined factors associated with condomless sexual intercourse.ResultsAmong N = 1508 participants above 18 years (58% males), 68% travelled post-migration (49.2% reported intercourse abroad). The overall proportion of condomless sex at last sexual intercourse was high (68.1%). The odds of condomless sex in the host country was five times higher when the last sexual intercourse abroad was also condomless [OR:5.32; 95%CI:2.98–9.25]. About half of the travellers reported concurrency, i.e. a regular partner in the host country while having other sexual partners abroad. Almost three percent of the participants reported being HIV+, but 5% had a reactive HIV test-result, with similar proportions among travellers and non-travellers. Also, among the n = 75 participants with reactive HIV test-results, condomless sex occurred (n = 40) and was associated with mobility.ConclusionsSub-Saharan African migrants are mobile and engage in sexual risk behaviours in the countries of residence and while travelling, increasing risk of post-migration HIV-acquisition. A transnational perspective on HIV prevention and sexual health promotion is needed for effectively reducing migrants’ HIV risk related to their mobility.
Highlights
People immigrating from high endemic countries to Europe are highly affected by HIV: 18% of all newly diagnosed cases with known origin in the European Union/European Economic Area in 2017 came from high HIV prevalence areas [1]
This study aims to explore risky sexual behaviour and HIV-acquisition among sub-Saharan African migrants, and to assess post-migration mobility as a determinant of sexual risk behaviour
Data from the European Surveillance System for 29 European countries estimated that Sub-Saharan African migrants (SAM) represented 53% of all HIV cases reported among people born outside the reporting countries, in 2007–2012 [2]
Summary
People immigrating from high endemic countries to Europe are highly affected by HIV: 18% of all newly diagnosed cases with known origin in the European Union/European Economic Area in 2017 came from high HIV prevalence areas [1]. Data from the European Surveillance System for 29 European countries estimated that Sub-Saharan African migrants (SAM) represented 53% of all HIV cases reported among people born outside the reporting countries, in 2007–2012 [2]. Belgium and Portugal, the two countries where this study was conducted serve as typical examples for European countries with colonial links affecting migration patterns. Both countries have high proportions of SAM among their populations of people living with HIV. This study aims to explore risky sexual behaviour and HIV-acquisition among sub-Saharan African migrants, and to assess post-migration mobility as a determinant of sexual risk behaviour
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