PLoS ONE
Volume 14, Issue 2, 2019

HIV diagnoses in migrant populations in Australia—A changing epidemiology (Article) (Open Access)

Gunaratnam P. , Heywood A.E. , McGregor S. , Jamil M.S. , McManus H. , Mao L. , Lobo R. , Brown G. , Hellard M. , Marukutira T. , Bretaña N.A. , Lang C. , Medland N. , Bavinton B. , Grulich A. , Guy R.
  • a Kirby Institute for Infection and Immunity, UNSW Sydney, Sydney, Australia
  • b School of Public Health and Community Medicine, UNSW Sydney, Sydney, Australia
  • c Kirby Institute for Infection and Immunity, UNSW Sydney, Sydney, Australia
  • d Kirby Institute for Infection and Immunity, UNSW Sydney, Sydney, Australia
  • e Kirby Institute for Infection and Immunity, UNSW Sydney, Sydney, Australia
  • f Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
  • g School of Public Health, Curtin University, Perth, Australia
  • h Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
  • i Burnet Institute, Melbourne, Australia
  • j Burnet Institute, Melbourne, Australia
  • k Kirby Institute for Infection and Immunity, UNSW Sydney, Sydney, Australia
  • l Communicable Diseases Branch, Queensland Department of Health, Brisbane, Australia
  • m Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia, Central Clinical School, Monash University, Melbourne, Australia
  • n Kirby Institute for Infection and Immunity, UNSW Sydney, Sydney, Australia
  • o Kirby Institute for Infection and Immunity, UNSW Sydney, Sydney, Australia
  • p Kirby Institute for Infection and Immunity, UNSW Sydney, Sydney, Australia

Abstract

Introduction We conducted a detailed analysis of trends in new HIV diagnoses in Australia by country of birth, to understand any changes in epidemiology, relationship to migration patterns and implications for public health programs. Methods Poisson regression analyses were performed, comparing the age-standardised HIV diagnosis rates per 100,000 estimated resident population between 2006–2010 and 2011–2015 by region of birth, with stratification by exposure (male-to-male sex, heterosexual sex–males and females). Correlation between the number of permanent and long-term arrivals was also explored using linear regression models. Results Between 2006 and 2015, there were 6,741 new HIV diagnoses attributed to male-to-male sex and 2,093 attributed to heterosexual sex, with the proportion of diagnoses attributed to male-to-male sex who were Australian-born decreasing from 72.5% to 66.5%. Compared with 2006–2010, the average annual HIV diagnosis rate per 100,000 in 2011–15 attributed to male-to-male sex was significantly higher in men born in South-East Asia (summary rate ratio (SRR) = 1.37, p = 0.001), North-East Asia (SRR = 2.18, p<0.001) and the Americas (SRR = 1.37, p = 0.025), but significantly lower as a result of heterosexual sex in men born in South-East Asia (SRR = 0.49, p = 0.002), Southern and Central Asia (SRR = 0.50, p = 0.014) and Sub-Saharan Africa (SRR = 0.39, p<0.001) and women born in South-East Asia (SRR = 0.61, p = 0.002) and Sub-Saharan Africa (SRR = 0.61, p<0.001). Positive associations were observed between the number of permanent and long-term arrivals and HIV diagnoses particularly in relation to diagnoses associated with male-to-male sex in men from North Africa and the Middle East, North Asia, Southern and Central Asia and the Americas. Conclusion The epidemiology of HIV in Australia is changing, with an increase in HIV diagnosis rates attributed to male-to-male sex amongst men born in Asia and the Americas. Tailored strategies must be developed to increase access to, and uptake of, prevention, testing and treatment in this group. © 2019 Gunaratnam et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Author Keywords

[No Keywords available]

Index Keywords

HIV Infections Africa south of the Sahara sexual behavior Human immunodeficiency virus infection Australia human middle aged Middle East controlled study nonhuman Human immunodeficiency virus resident Homosexuality, Male male homosexuality heterosexuality Young Adult Humans migrant male stratification female risk factor Risk Factors Western Hemisphere linear regression analysis Article adult migration human experiment North Africa Transients and Migrants
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85061523940&doi=10.1371%2fjournal.pone.0212268&partnerID=40&md5=7e288babb298278dcd134ae54885a769
DOI: 10.1371/journal.pone.0212268
ISSN: 19326203
Cited by: 2
Original Language: English