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Review
. 2018 Feb;31(1):25-32.
doi: 10.1097/QCO.0000000000000415.

HIV outcomes among migrants from low-income and middle-income countries living in high-income countries: a review of recent evidence

Jonathan Ross  1 , Chinazo O Cunningham  1 , David B Hanna  2
Affiliations
Review

HIV outcomes among migrants from low-income and middle-income countries living in high-income countries: a review of recent evidence

Jonathan Ross et al. Curr Opin Infect Dis. 2018 Feb.

Abstract

Purpose of review: Migrants living in high-income countries are disproportionately affected by HIV infection and frequently have characteristics associated with poor HIV clinical outcomes. HIV epidemiology among migrants is influenced by changes in migration patterns and variations in transmission risk behaviors. Here we review the recently published literature on known HIV outcomes among migrants from low-income and middle-income countries living in high-income countries.

Recent findings: High proportions of migrants acquire HIV after migration, and this group frequently presents to care late. Once established in care, migrants are often more likely to experience worse HIV treatment outcomes compared with native populations. Multiple individual and structural factors influence HIV diagnosis and treatment outcomes among migrants, including disruption of social networks, increased sexual risk behaviors, communication barriers, limited access to care, and stigma. Few studies have examined interventions targeted at improving HIV outcomes among migrants.

Summary: Stigma and limited access to care appear to be primary drivers of poor HIV outcomes among migrants in high-income countries. Addressing these disparities is limited by difficulties in identifying and monitoring this population as well as a lack of evidence regarding appropriate interventions for migrants living with HIV. Improving outcomes for this group requires interventions that are specifically targeted at this marginalized and growing population.

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Conflict of interest statement

Conflicts of interest

Dr. Cunningham’s husband is an employee of Quest Diagnostics and they own stock and stock options in Quest Diagnostics. All other authors report no potential conflicts of interest.

Figures

Figure 1
Figure 1
Map showing the percentage of migrants among new HIV diagnoses in high-income countries, based on surveillance data. (A) Canada, 2015 (migrants defined based on heterosexual contact and born in an HIV-endemic country) [9]; United States, 2010–2014 [10], (B) Australia, 2016 [Surveillance Evaluation and Research Program, Kirby Institute, University of New South Wales Sydney, personal communication, September 2017], (C) European Union/European Economic Area, 2015 [8]. Legend: Percent migrants among new HIV diagnoses in high-income countries
See this image and copyright information in PMC

References

    1. United Nations, Department of Economic and Social Affairs, Population Division. International Migration Report 2015: Highlights (ST/ESA/SER.A/375) 2016.
    1. Bowsher GM, Krishnan RA, Shanahan TA, et al. Immigration Act 2014 challenges health of migrants in the UK. Lancet. 2015;385(9971):852–3. - PubMed
    1. Ramirez SM, Villarejo D. Poverty, housing, and the rural slum: policies and the production of inequities, past and present. Am J Public Health. 2012;102(9):1664–75. - PMC - PubMed
    1. Geltman PL, Adams JH, Cochran J, et al. The impact of functional health literacy and acculturation on the oral health status of Somali refugees living in Massachusetts. Am J Public Health. 2013;103(8):1516–23. - PMC - PubMed
    1. Rechel B, Mladovsky P, Ingleby D, et al. Migration and health in an increasingly diverse Europe. Lancet. 2013;381(9873):1235–45. - PubMed

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