@article{3001003,
    title = "High levels of postmigration HIV acquisition within nine European countries",
    author = "Alvarez-Del Arco, D. and Fakoya, I. and Thomadakis, C. and Pantazis, N. and Touloumi, G. and Gennotte, A.-F. and Zuure, F. and Barros, H. and Staehelin, C. and Göpel, S. and Boesecke, C. and Prestileo, T. and Volny-Anne, A. and Burns, F. and Del Amo, J. and Aerssens, A. and Aguado, M. and Alimi, B. and Álvarez-Del Arco, D. and Anagnostou, O. and Anderson, J. and Antoniadou, A. and Arando, M. and Barberà, M.J. and Barthélemy, A. and Belda-Ibáñez, J. and Bertisch, B. and Bil, J. and Blanco, J.R. and Block, K. and Boesecke, C. and Boura, M. and Burgos, J. and Burns, F.M. and Cabo, J. and Calabuig, E. and Campbell, L. and Cardoso, O. and Claudia, W. and Clumeck, N. and Colucci, A. and Corrao, S. and Cuellar, S. and Cunha, J. and Daikos, G. and Darling, K. and Del Amo, J. and Del Romero, J. and Dellot, P. and Dixneuf, M. and Domingo, P. and Dronda, F. and Ebeling, F. and Engelhardt, A. and Engler, B. and Fakoya, I. and Farrell, J. and Fehr, J. and Feijó, M. and Fernández, E. and Fernández García, E. and Fernandez, T. and Fortes, A.L. and Fox, J. and Garcia De Olalla, P. and García, F. and Gargalianos-Kakolyris, P. and Gennotte, A.F. and Germano, I. and Gilleran, G. and Gilson, R. and Goepel, S. and Gogos, H.A. and Gómez Sirvent, J.L. and Gountas, I. and Gregg, A. and Gutiérrez, F. and Gutierrez, M.M. and Hermans, I. and Iribarren, J.A. and Knobel, H. and Koulai, L. and Kourkounti, S. and La Morté, C. and LeCompte, T. and Ledergerber, B. and Leonidou, L. and Ligero, M.C. and Lindergard, G. and Lino, S. and Lopes, M.J. and Lopez Lirola, A. and Louhenapessy, M. and Lourida, G. and Luzi, A.M. and Maltez, F. and Manirankunda, L. and Martín-Pérez, A. and Martins, L. and Masía, M. and Mateu, M.G. and Meireles, P. and Mendes, A. and Metallidis, S. and Mguni, S. and Milinkovic, A. and Miró, J.M. and Mohrmann, K. and Monge, S. and Montero, M. and Mouhebati, T. and Moutschen, M. and Müller, M. and Murphy, C. and Nöstlinger, C. and Ocaña, I. and Okumu-Fransche, S. and Onwuchekwa, G. and Ospina, J.E. and Otiko, D. and Pacheco, P. and Palacios, R. and Paparizos, V. and Papastamopoulos, V. and Paredes, V. and Patel, N. and Pellicer, T. and Peña, A. and Petrosillo, N. and Pinheiro, A. and Poças, J. and Portillo, A. and Post, F. and Prestileo, F. and Prestileo, T. and Prins, M. and Prins, P. and Protopapas, K. and Psichogiou, M. and Pulido, F. and Rebollo, J. and Ribeirinho, A. and Río, I. and Robau, M. and Rockstroh, J.K. and Rodrigues, E. and Rodríguez, M. and Sajani, C. and Salavert, M. and Salman, R. and Sanz, N. and Schuettfort, G. and Schüttfort, G. and Schwarze-Zander, C. and Serrão, R. and Silva, D. and Silva, V. and Silverio, P. and Skoutelis, A. and Staehelin, C. and Stephan, C. and Stretton, C. and Styles, F. and Sutre, A.F. and Taylor, S. and Teixeira, B. and Thierfelder, C. and Touloumi, G. and Tsachouridou, O. and Tudor, K. and Valadas, E. and Van Frankenhuijsen, M. and Vázquez, M. and Velasco Arribas, M. and Vera, M. and Vinciana, P. and Volny-Anne, A. and Voudouri, N. and Wasmuth, J.C. and Wengenroth, C. and Wilkins, E. and Young, L. and Yurdakul, S. and Zafra Espinosa, T. and Zuilhof, W. and Zuure, F. and Advancing Migrant Access to Health Services in Europe (aMASE) study team",
    journal = "Ελληνικά Αρχεία AIDS=:  Hellenic Archives of AIDS",
    year = "2017",
    volume = "31",
    number = "14",
    pages = "1979-1988",
    publisher = "Lippincott Williams and Wilkins",
    issn = "11058900",
    doi = "10.1097/QAD.0000000000001571",
    keywords = "virus RNA, adult;  Africa south of the Sahara;  age;  Article;  Bayes theorem;  Caribbean;  CD4 lymphocyte count;  cross-sectional study;  Europe;  female;  heterosexual female;  heterosexual male;  human;  Human immunodeficiency virus infection;  logistic regression analysis;  major clinical study;  male;  men who have sex with men;  middle aged;  migrant;  migration;  priority journal;  questionnaire;  risk factor;  seroconversion;  South and Central America;  young adult;  adolescent;  aged;  blood;  clinical trial;  Europe;  Human immunodeficiency virus infection;  multicenter study;  risk assessment;  very elderly;  virus load, Adolescent;  Adult;  Aged;  Aged, 80 and over;  CD4 Lymphocyte Count;  Cross-Sectional Studies;  Europe;  Female;  HIV Infections;  Humans;  Male;  Middle Aged;  Risk Assessment;  RNA, Viral;  Surveys and Questionnaires;  Transients and Migrants;  Viral Load;  Young Adult",
    abstract = "Objective: We aimed to estimate the proportion of postmigration HIV acquisition among HIV-positive migrants in Europe. Design: To reach HIV-positive migrants, we designed a cross-sectional study performed in HIV clinics. Methods: The study was conducted from July 2013 to July 2015 in 57 clinics (nine European countries), targeting individuals over 18 years diagnosed in the preceding 5 years and born abroad. Electronic questionnaires supplemented with clinical data were completed in any of 15 languages. Postmigration HIV acquisition was estimated through Bayesian approaches combining extensive information on migration and patients' characteristics. CD4+ cell counts and HIV-RNA trajectories from seroconversion were estimated by bivariate linear mixed models fitted to natural history data. Postmigration acquisition risk factors were investigated with weighted logistic regression. Results: Of 2009 participants, 46% were MSM and a third originated from sub-Saharan Africa and Latin America & Caribbean, respectively. Median time in host countries was 8 years. Postmigration HIV acquisition was 63% (95% confidence interval: 57-67%); 72% among MSM, 58 and 51% in heterosexual men and women, respectively. Postmigration HIV acquisition was 71% for Latin America and Caribbean migrants and 45% for people from sub-Saharan Africa. Factors associated with postmigration HIV acquisition among heterosexual women and MSM were age at migration, length of stay in host country and HIV diagnosis year and among heterosexual men, length of stay in host country and HIV diagnosis year. Conclusion: A substantial proportion of HIV-positive migrants living in Europe acquired HIV postmigration. This has important implications for European public health policies. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved."
}