Infection
Volume 46, Issue 5, 2018, Pages 659-667

Refugees and family-reunified immigrants have a high incidence of HIV diagnosis and late presentation compared with Danish born: a nationwide register-based cohort study (Article)

Deen L. , Cowan S. , Wejse C.* , Petersen J.H. , Norredam M. , ESCMID Study Group for Infections in Travellers and Migrants
  • a Section of Immigrant Medicine, Department of Infectious Disease, Copenhagen University Hospital, Kettegård Alle 30, Hvidovre, 2650, Denmark
  • b Department of Infectious Disease Epidemiology, Statens Serum Institut, Artillerivej 5, Copenhagen S, 2300, Denmark
  • c Department of Public Health, Centre for Global Health, Aarhus University, Bartholins Allé 2, Aarhus C, 8000, Denmark, Department of Infectious Diseases, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus N, 8200, Denmark
  • d Section of Biostatistics, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Copenhagen K, 1014, Denmark
  • e Section of Immigrant Medicine, Department of Infectious Disease, Copenhagen University Hospital, Kettegård Alle 30, Hvidovre, 2650, Denmark, Danish Research Centre for Migration, Ethnicity and Health (MESU), Department of Public Health, Section for Health Services Research, University of Copenhagen, Øster Farimagsgade 5, Copenhagen K, 1014, Denmark
  • f [Affiliation not available]

Abstract

Purpose: Migrants represent a considerable proportion of HIV diagnoses in Europe and are considered a group at risk of late presentation. This study examined the incidence of HIV diagnoses and the risk of late presentation according to migrant status, ethnic origin and duration of residence. Methods: We conducted a historically prospective cohort study comprising all adult migrants to Denmark between 1.1.1993 and 31.12.2010 (n = 114.282), matched 1:6 to Danish born by age and sex. HIV diagnoses were retrieved from the National Surveillance Register and differences in incidence were assessed by Cox regression model. Differences in late presentation were assessed by logistic regression. Results: Both refugees (HR = 5.61; 95% CI 4.45–7.07) and family-reunified immigrants (HR = 10.48; 95% CI 8.88–12.36) had higher incidence of HIV diagnoses compared with Danish born and the incidence remained high over time of residence for both groups. Migrants from all regions, except Western Asia and North Africa, had higher incidence than Danish born. Late presentation was more common among refugees (OR = 1.87; 95% CI 1.07–3.26) and family-reunified immigrants (OR = 2.30; 95% CI 1.49–3.55) compared with Danish born. Southeast Asia and Sub-Saharan Africa were the only regions with a higher risk of late presentation. Late presentation was only higher for refugees within 1 year of residence, whereas it remained higher within 10 years of residence for family-reunified immigrants. Conclusions: This register-based study revealed a higher incidence of HIV diagnoses and late presentation among migrants compared with Danish born and the incidence remained surprisingly high over time. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.

Author Keywords

Ethnic minority Migrants Late presentation HIV infection Refugee

Index Keywords

prospective study immigrant proportional hazards model Africa south of the Sahara HIV Infections Registries refugee Proportional Hazards Models Human immunodeficiency virus infection register human risk assessment Refugees middle aged Odds Ratio Denmark ethnic group controlled study Public Health Surveillance Humans migrant virology Danish citizen male Emigrants and Immigrants family reunified immigrant female Socioeconomic Factors CD4 lymphocyte count Southeast Asia socioeconomics high risk population Incidence Article major clinical study adult cohort analysis health survey
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85049570021&doi=10.1007%2fs15010-018-1167-8&partnerID=40&md5=b84a42ee22db49872259648a3e9920e6
DOI: 10.1007/s15010-018-1167-8
ISSN: 03008126
Cited by: 1
Original Language: English