The majority of migrants living with HIV in Europe became infected after arriving to their new country – debunking the previously held assumption that HIV infections among migrants are imported.
In 2015, some 29,747 new diagnoses were reported in Europe, and information on where these people acquired their infection was available for 25,785 of these. Around 37% of these were in migrants (classified as people originating from outside their reporting country), and 15% of these infections were people from countries with generalised epidemics.
In a cross-sectional survey performed at HIV clinics from nine countries in the European Union and European Economic Area (EEA), results revealed that some 63% of HIV-positive migrants became infected after they had migrated to their new country.
Post-migration HIV acquisition was higher in migrants from Europe (71%) and Latin America and the Caribbean (71%), compared with migrants from sub-Saharan Africa (45%). The proportion was also higher among men who have sex with men (sometimes referred to as MSM) than among heterosexual men and women, with 72% of men who have sex with men acquiring HIV post-migration, compared to 58% of heterosexual men and 51% of heterosexual women.
The research showed that this 72% HIV acquisition rate among migrant men who have sex with men happened regardless of their country origin. The authors note that migrant men who have sex with men often come from countries where prevalence among men who have sex with men is lower than in the European cities they migrate to. They also often migrate from societies that are largely homophobic, and may suffer from stigma – both internalised and from the communities around them. These factors may explain increased rates of HIV acquisition after migration.
While most EU countries consider migrants a priority population – many interventions are based on the assumption that HIV infections were acquired abroad. Adequate prevention and testing strategies are needed to ensure these services reach this population group.