Section of Immigrant Medicine, Department of Infectious Disease, Copenhagen University Hospital, Kettegård Alle 30, 2650, Hvidovre, Denmark.
Department of Infectious Disease Epidemiology, Statens Serum Institut, Artillerivej 5, 2300, Copenhagen S, Denmark.
Infection. 2018 Oct;46(5):659-667. doi: 10.1007/s15010-018-1167-8. Epub 2018 Jul 3.
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.
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.
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.
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.
移民在欧洲的艾滋病病毒诊断中占相当大的比例，被认为是有晚期出现风险的群体。本研究根据移民身份、族裔和居住时间，检查了艾滋病病毒诊断的发生率和晚期出现的风险。
我们进行了一项历史前瞻性队列研究，纳入了 1993 年 1 月 1 日至 2010 年 12 月 31 日期间所有移民到丹麦的成年人（n=114282），按年龄和性别与丹麦出生者 1:6 匹配。艾滋病病毒诊断从国家监测登记处获取，用 Cox 回归模型评估发病率差异。用 logistic 回归评估晚期出现的差异。
难民（HR=5.61；95%CI 4.45-7.07）和家庭团聚移民（HR=10.48；95%CI 8.88-12.36）的艾滋病病毒诊断发生率均高于丹麦出生者，两组的发病率在居住时间内一直较高。除西亚和北非外，来自所有地区的移民的发病率均高于丹麦出生者。难民（OR=1.87；95%CI 1.07-3.26）和家庭团聚移民（OR=2.30；95%CI 1.49-3.55）的晚期出现率均高于丹麦出生者。东南亚和撒哈拉以南非洲是唯一晚期出现风险较高的地区。难民只有在居住 1 年内的晚期出现率较高，而家庭团聚移民则在居住 10 年内的晚期出现率较高。
这项基于登记的研究表明，与丹麦出生者相比，移民的艾滋病病毒诊断发生率和晚期出现率较高，而且发病率随着时间的推移仍然出人意料地高。
