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. 2022 Sep 17:53:101661.
doi: 10.1016/j.eclinm.2022.101661. eCollection 2022 Nov.

HIV prevalence ratio of international migrants compared to their native-born counterparts: A systematic review and meta-analysis

Devy Santoso  1 , Siti K B M Asfia  1 , Maeve B Mello  2 , Rachel C Baggaley  2 , Cheryl C Johnson  2 , Eric P F Chow  1   3   4 , Christopher K Fairley  1   3 , Jason J Ong  1   3   5
Affiliations

HIV prevalence ratio of international migrants compared to their native-born counterparts: A systematic review and meta-analysis

Devy Santoso et al. EClinicalMedicine. .

Abstract

Background: People on the move, including international migrants, may face health inequities that expose them to a higher risk for HIV than native-born populations. We conducted a systematic review to calculate the HIV prevalence ratio of international migrants compared with native-born populations.

Methods: We searched five databases between January 2010 and March 2022. Using random-effects meta-analysis, we calculated the pooled HIV prevalence ratios (PR) by comparing the HIV prevalence of migrants with native-born populations. Our research protocol is registered in the International prospective register of systematic reviews (PROSPERO, CRD42021250867).

Findings: In total, 5,121 studies were screened, and 38 were included in the final analysis: 7,121,699 migrants and more than 270 million natives were included in the analysis. The pooled PR for any foreign-born migrants was 1·70 (95% CI 1·11 - 2·61, I2 =99·67%, n = 33 studies), refugees was 2·37 (95% CI 0·33-16·99, I2 =99·5%, n = 5), undocumented people was 3·98 (95% CI 0·11-143·01, I2 =94·6%, n = 3), whilst asylum seekers was 54·79 (95% CI 17·23-174·23, I2 =90·2%, n = 2). Meta-regression revealed that population type (adjusted R-squared 11.5%), region of origin (11.3%) and migrant type (10.8%) accounted for heterogeneity more than country-income (2.4%) and study setting (2.3%).

Interpretation: Although it was not possible to assess if HIV infection occurred in the country of origin or destination, the HIV prevalence ratio was higher among migrants than in native-born populations. Inclusive health policies and strategies for delivering HIV testing, prevention and treatment services for migrant populations tailored to their needs are urgently needed.

Funding: J.J.O. and E.P.F.C. are supported by the Australian National Health and Medical Research Council (NHMRC) Emerging Leader Fellowship (GNT1193955 and GNT1172873, respectively).

Keywords: HIV; asylum seekers; migrants; native-born; people on the move; prevalence; refugees.

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Conflict of interest statement

We declare no competing interests.

Figures

Figure 1
Figure 1
PRISMA flowchart of the search strategy used in this meta-analysis. The right-hand side indicates the results from the updated search (2022).
Figure 2
Figure 2
Countries and regions of studies (n = 38).
Figure 3
Figure 3
Forest plot of prevalence ratios comparing HIV prevalence among migrants compared with native-born populations, by migrant type.
Figure 4
Figure 4
Forest plot of prevalence ratios comparing HIV prevalence among migrants compared with native-born populations, by migrants’ region of birth.
Figure 4
Figure 4
Forest plot of prevalence ratios comparing HIV prevalence among migrants compared with native-born populations, by migrants’ region of birth.
Figure 5
Figure 5
Forest plot of prevalence ratios comparing HIV prevalence of migrants compared with native-born populations, by country income level of the destination country.
Figure 6
Figure 6
Forest plot of prevalence ratios comparing HIV prevalence of migrants compared with native-born populations, by population type.
See this image and copyright information in PMC

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