NOVA National School of Public Health, Public Health Research Centre & Global Health and Tropical Medicine, Universidade NOVA de Lisboa, Lisboa, Portugal.
Comprehensive Health Research Centre (CHRC), Lisboa, Portugal.
PLoS One. 2020 Feb 5;15(2):e0228584. doi: 10.1371/journal.pone.0228584. eCollection 2020.
Migrants from high endemic countries accounted for 18% of newly diagnosed HIV infections in Europe in 2017. Knowledge on the link between HIV risk and post-migration travels and their impact on HIV acquisition is scarce, but critical to inform prevention. This study aims to explore risky sexual behaviour and HIV-acquisition among sub-Saharan African migrants, and to assess post-migration mobility as a determinant of sexual risk behaviour.
Data from two cross-sectional bio-behavioural surveys to assess HIV-prevalence conducted in Lisbon and Antwerp were analysed to explore migration-related characteristics, travel patterns, and sexual risk taking in the host country and abroad. Bi- and multivariate associations were estimated through adjusted odds ratios and 95% confidence intervals; multivariable logistic regression determined factors associated with condomless sexual intercourse.
Among N = 1508 participants above 18 years (58% males), 68% travelled post-migration (49.2% reported intercourse abroad). The overall proportion of condomless sex at last sexual intercourse was high (68.1%). The odds of condomless sex in the host country was five times higher when the last sexual intercourse abroad was also condomless [OR:5.32; 95%CI:2.98-9.25]. About half of the travellers reported concurrency, i.e. a regular partner in the host country while having other sexual partners abroad. Almost three percent of the participants reported being HIV+, but 5% had a reactive HIV test-result, with similar proportions among travellers and non-travellers. Also, among the n = 75 participants with reactive HIV test-results, condomless sex occurred (n = 40) and was associated with mobility.
Sub-Saharan African migrants are mobile and engage in sexual risk behaviours in the countries of residence and while travelling, increasing risk of post-migration HIV-acquisition. A transnational perspective on HIV prevention and sexual health promotion is needed for effectively reducing migrants' HIV risk related to their mobility.
2017 年，高流行国家的移民占欧洲新诊断出的 HIV 感染人数的 18%。关于 HIV 风险与移民后旅行之间的联系及其对 HIV 感染的影响的知识很少，但对于提供预防信息至关重要。本研究旨在探索撒哈拉以南非洲移民的性行为风险和 HIV 感染情况，并评估移民后的流动情况作为性行为风险的决定因素。
对在里斯本和安特卫普进行的两项评估 HIV 流行率的横断面生物行为调查的数据进行了分析，以探讨与移民相关的特征、旅行模式以及在东道国和国外的性行为风险。通过调整后的优势比和 95%置信区间来估计双变量和多变量关联；多变量逻辑回归确定与无保护性行为相关的因素。
在 1508 名年龄在 18 岁以上的参与者中（58%为男性），68%在移民后旅行（49.2%报告在国外发生性行为）。最后一次性行为中不使用安全套的总体比例很高（68.1%）。当最后一次性行为在国外也不使用安全套时，在东道国发生无保护性行为的几率要高出五倍[比值比：5.32；95%置信区间：2.98-9.25]。约一半的旅行者报告有同时性伴侣，即在东道国有一个固定伴侣，同时在国外还有其他性伴侣。大约有 3%的参与者报告 HIV 阳性，但有 5%的人 HIV 检测结果呈阳性反应，旅行者和非旅行者的比例相似。此外，在 n = 75 名 HIV 检测结果呈阳性反应的参与者中，有 n = 40 名发生了无保护性行为，且与流动性相关。
撒哈拉以南非洲移民流动性强，在居住国和旅行期间从事性行为风险行为，增加了移民后 HIV 感染的风险。需要从跨国视角出发，制定 HIV 预防和性健康促进措施，有效降低移民因流动性而产生的 HIV 风险。
