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SDG 3: HIV/AIDS

Abstract

Background

Recent migration trends have shown a notable entry of Latin American asylum seekers to Madrid, Spain.

Aim

To characterise the profile of asylum-seeking Latin American migrants who are living with HIV in Spain and to outline the barriers they face in accessing HIV treatment.

Methods

A prospective cohort study was conducted between 2022 and 2023 with a 6-month follow-up period. Latin American asylum seekers living with HIV were recruited mainly from non-governmental organisations and received care at an HIV clinic in a public hospital in Madrid.

Results

We included 631 asylum seekers. The primary countries of origin were Colombia (30%), Venezuela (30%) and Peru (18%). The median age was 32 years (interquartile range (IQR): 28–37), and 553 (88%) were cis men of which 94% were men who have sex with men. Upon their arrival, 49% (n = 309) lacked social support, and 74% (n = 464) faced barriers when attempting to access the healthcare system. Upon entry in Europe, 500 (77%) participants were taking antiretroviral therapy (ART). At their first evaluation at the HIV clinic, only 386 (61%) had continued taking ART and 33% (n = 209) had detectable plasma HIV-1 RNA levels. Six months later, 99% took ART and 98% had achieved an undetectable viral load.

Conclusions

Latin American asylum seekers living with HIV in Madrid, Spain encountered barriers to healthcare and to ART. One-third of these individuals presented detectable HIV viral load when assessed in the HIV clinic, highlighting this as an important public health issue.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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2024-07-18
2024-12-21
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References

  1. Bekker LG, Beyrer C, Mgodi N, Lewin SR, Delany-Moretlwe S, Taiwo B, et al. HIV infection. Nat Rev Dis Primers. 2023;9(1):42.  https://doi.org/10.1038/s41572-023-00452-3  PMID: 37591865 
  2. Lazarus JV, Safreed-Harmon K, Kamarulzaman A, Anderson J, Leite RB, Behrens G, et al. Consensus statement on the role of health systems in advancing the long-term well-being of people living with HIV. Nat Commun. 2021;12(1):4450.  https://doi.org/10.1038/s41467-021-24673-w  PMID: 34272399 
  3. World Health Organization (WHO). Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach, 2nd ed. Geneva: WHO; 2016. Available from: https://www.who.int/publications/i/item/9789241549684
  4. Fielden SJ, Rusch MLA, Yip B, Wood E, Shannon K, Levy AR, et al. Nonadherence increases the risk of hospitalization among HIV-infected antiretroviral naive patients started on HAART. J Int Assoc Physicians AIDS Care (Chic). 2008;7(5):238-44.  https://doi.org/10.1177/1545109708323132  PMID: 18812590 
  5. Lifson AR, Grund B, Gardner EM, Kaplan R, Denning E, Engen N, et al. Improved quality of life with immediate versus deferred initiation of antiretroviral therapy in early asymptomatic HIV infection. AIDS. 2017;31(7):953-63.  https://doi.org/10.1097/QAD.0000000000001417  PMID: 28121710 
  6. Pérez-Elías MJ, Podzamczer Palter D, Ventayol Bosch P, Jarrín I, Castro A, Rubio-Rodríguez D, et al. Clinical and economic benefit of 32 years of antiretroviral treatment for people living with HIV in Spain: Has it been an efficient intervention? Enferm Infecc Microbiol Clin (Engl Ed). 2022;40(10):550-6.  https://doi.org/10.1016/j.eimce.2021.05.011  PMID: 34303633 
  7. Lundgren JD, Babiker AG, Gordin F, Emery S, Grund B, Sharma S, et al. Initiation of antiretroviral therapy in early asymptomatic HIV infection. N Engl J Med. 2015;373(9):795-807.  https://doi.org/10.1056/NEJMoa1506816  PMID: 26192873 
  8. Rodger AJ, Cambiano V, Bruun T, Vernazza P, Collins S, van Lunzen J, et al. Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV-positive partner is using suppressive antiretroviral therapy. JAMA. 2016;316(2):171-81.  https://doi.org/10.1001/jama.2016.5148  PMID: 27404185 
  9. Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493-505.  https://doi.org/10.1056/NEJMoa1105243  PMID: 21767103 
  10. World Health Organization (WHO). Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach. Geneva: WHO; 16 Jul 2021. Available from: https://www.who.int/news/item/16-07-2021-who-publishes-new-consolidated-hiv-guidelines-for-prevention-treatment-service-delivery-monitoring
  11. The Joint United Nations Programme on HIV/AIDS (UNAIDS). Fast-Track - Ending the AIDS epidemic by 2030. Geneva; UNAIDS; 18 Nov 2014. Available from: https://www.unaids.org/en/resources/documents/2014/JC2686_WAD2014report
  12. The UN Refugee Agency (UNHCR). The 1951 Refugee Convention. Geneva; UNHCR. [Accessed: 1 Sep 2023]. Available from: https://www.unhcr.org/about-unhcr/who-we-are/1951-refugee-convention
  13. Ministerio de Sanidad. Barreras y dificultades en el acceso a la atención y tratamiento de las personas migrantes y solicitantes de asilo con el VIH en España. [Barriers and difficulties in access to care and treatment for migrants and asylum seekers with HIV in Spain.] Madrid: Ministerio de Sanidad; 2022. Spanish. Available from: https://www.sanidad.gob.es/ciudadanos/enfLesiones/enfTransmisibles/sida/INFORMES/DificultadesAccesoServiciosSanitarios_Final_2022.pdf
  14. Eurostat. Asylum (migr-asy). Luxembourg: Eurostat. [Accessed: 11 Aug 2023]. Available from: https://ec.europa.eu/eurostat/databrowser/explore/all/popul?lang=en&subtheme=migr.migr_asy&display=list&sort=category
  15. European Centre for Disease Prevention and Control (ECDC). Continuum of HIV care - Monitoring implementation of the Dublin Declaration on partnership to fight HIV/AIDS in Europe and Central Asia: 2021 progress report. Stockholm: ECDC; 2022. Available from: https://www.ecdc.europa.eu/en/publications-data/continuum-hiv-care-monitoring-implementation-dublin-declaration-partnership-fight
  16. Deblonde J, Sasse A, Del Amo J, Burns F, Delpech V, Cowan S, et al. Restricted access to antiretroviral treatment for undocumented migrants: a bottle neck to control the HIV epidemic in the EU/EEA. BMC Public Health. 2015;15(1):1228.  https://doi.org/10.1186/s12889-015-2571-y  PMID: 26654427 
  17. Lebano A, Hamed S, Bradby H, Gil-Salmerón A, Durá-Ferrandis E, Garcés-Ferrer J, et al. Migrants’ and refugees’ health status and healthcare in Europe: a scoping literature review. BMC Public Health. 2020;20(1):1039.  https://doi.org/10.1186/s12889-020-08749-8  PMID: 32605605 
  18. Wirtz AL, Guillén JR, Stevenson M, Ortiz J, Talero MÁB, Page KR, et al. HIV infection and engagement in the care continuum among migrants and refugees from Venezuela in Colombia: a cross-sectional, biobehavioural survey. Lancet HIV. 2023;10(7):e461-71.  https://doi.org/10.1016/S2352-3018(23)00085-1  PMID: 37302399 
  19. Kronfli N, Linthwaite B, Sheehan N, Cox J, Hardy I, Lebouché B, et al. Delayed linkage to HIV care among asylum seekers in Quebec, Canada. BMC Public Health. 2019;19(1):1683.  https://doi.org/10.1186/s12889-019-8052-y  PMID: 31842822 
  20. Gonzalez-Baeza A, Fernández-Ollero M, Manzano S, Deihim-Pahampour N. Psychological distress in HIV-infected undocumented migrants recently arrived in Spain: a higher vulnerability of people with HIV-related stigma and early adverse events. 19th European AIDS Conference; 18-21 Oct 2023, Warsaw, Poland. Oral Communication 702.
  21. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377-81.  https://doi.org/10.1016/j.jbi.2008.08.010  PMID: 18929686 
  22. European Union Agency for Fundamental Rights (FRA). Current migration situation in the EU: Lesbian, gay, bisexual, transgender and intersex asylum seekers. Luxembourg: Publication Office of the European Union; 2017. Available from: https://fra.europa.eu/sites/default/files/fra_uploads/fra-march-2017-monthly-migration-report-focus-lgbti_en.pdf
  23. Fakoya I, Álvarez-del Arco D, Woode-Owusu M, Monge S, Rivero-Montesdeoca Y, Delpech V, et al. A systematic review of post-migration acquisition of HIV among migrants from countries with generalised HIV epidemics living in Europe: mplications for effectively managing HIV prevention programmes and policy. BMC Public Health. 2015;15(1):561.  https://doi.org/10.1186/s12889-015-1852-9  PMID: 26085030 
  24. Weine SM, Kashuba AB. Labor migration and HIV risk: a systematic review of the literature. AIDS Behav. 2012;16(6):1605-21.  https://doi.org/10.1007/s10461-012-0183-4  PMID: 22481273 
  25. Woodward A, Howard N, Wolffers I. Health and access to care for undocumented migrants living in the European Union: a scoping review. Health Policy Plan. 2014;29(7):818-30.  https://doi.org/10.1093/heapol/czt061  PMID: 23955607 
  26. Fakoya I, Álvarez-Del Arco D, Copas AJ, Teixeira B, Block K, Gennotte AF, et al. Factors associated with access to HIV testing and primary care among migrants living in Europe: cross-sectional survey. JMIR Public Health Surveill. 2017;3(4):e84.  https://doi.org/10.2196/publichealth.7741  PMID: 29109072 
  27. United Nations (UN) President or the General Assembly. Draft outcome document of the conference: intergovernmental conference to adopt the global compact for safe, orderly and regular migration. New York: UN; 2018. Available from: https://digitallibrary.un.org/record/1640477
  28. United Nations (UN). Universal Declaration of Human Rights. New York: UN. [Accessed: 3 Sep 2023]. Available from: https://www.un.org/en/about-us/universal-declaration-of-human-rights
  29. Ministerio de la Presidencia, Justicia y Relaciones con las Cortes. Real Decreto-ley 7/2018, de 27 de julio, sobre el acceso universal al Sistema Nacional de Salud. [Royal Decree-Law 7/2018, 27 July 2018, on universal access to the National Health System]. Madrid: Ministerio de la Presidencia, Justicia y Relaciones con las Cortes; 2018. Spanish. Available from: https://www.boe.es/eli/es/rdl/2018/07/27/7
  30. Ministerio de Sanidad. Vigilancia epidemiológica del VIH y sida en España 2019. [Epidemiological surveillance of HIV and AIDS in Spain 2019]. Madrid: Ministerio de Sanidad; 2020. Spanish. Available from: https://www.sanidad.gob.es/ciudadanos/enfLesiones/enfTransmisibles/sida/vigilancia/docs/Informe_VIH_SIDA_20201130.pdf
  31. Alvarez-Del Arco D, Fakoya I, Thomadakis C, Pantazis N, Touloumi G, Gennotte AF, et al. ; High levels of postmigration HIV acquisition within nine European countries. AIDS. 2017;31(14):1979-88.  https://doi.org/10.1097/QAD.0000000000001571  PMID: 28857779 
  32. Ryan P, Dolengevich-Segal H, Ramos-Ruperto L, Cabello A, Sanchez-Conde M, Vergas J, et al. Patterns of sexualized drug use among gay, bisexual, and other men who have sex with men living with HIV: insights from a comprehensive study—the U-SEX-2 GESIDA 9416 Study. J Clin Med. 2023;12(23):7293.  https://doi.org/10.3390/jcm12237293  PMID: 38068345 
  33. Pimentel V, Pingarilho M, Alves D, Diogo I, Fernandes S, Miranda M, et al. Molecular epidemiology of HIV-1 infected migrants followed up in Portugal: Trends between 2001-2017. Viruses. 2020;12(3):268.  https://doi.org/10.3390/v12030268  PMID: 32121161 
  34. Maggiorella MT, Sanarico N, Brindicci G, Monno L, Santoro CR, Coppola N, et al. High HIV-1 diversity in immigrants resident in Italy (2008-2017). Sci Rep. 2020;10(1):3226.  https://doi.org/10.1038/s41598-020-59084-2  PMID: 32094387 
  35. Izquierdo R, Rava M, Moreno-García E, Blanco JR, Asensi V, Cervero M, et al. HIV medical care interruption among people living with HIV in Spain, 2004-2020. AIDS. 2023;37(8):1277-84.  https://doi.org/10.1097/QAD.0000000000003552  PMID: 36939068 
HIV-infected Latin American asylum seekers in Madrid, Spain, 2022: A prospective cohort study from a major gateway in Europe
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Pablo+Ryan&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ryan Pablo</a>, <a href="/search?value1=Samuel+Manzano&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Manzano Samuel</a>, <a href="/search?value1=Neda+Deihim-Rahampour&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Deihim-Rahampour Neda</a>, <a href="/search?value1=Guillermo+Cuevas&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Cuevas Guillermo</a>, <a href="/search?value1=Laura+Martin-Gonzalez&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Martin-Gonzalez Laura</a>, <a href="/search?value1=Alicia+Gonzalez-Baeza&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gonzalez-Baeza Alicia</a>, <a href="/search?value1=Pedro+Torres&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Torres Pedro</a>, <a href="/search?value1=Jeffrey+V+Lazarus&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lazarus Jeffrey V</a>, <a href="/search?value1=Juan+Torres-Macho&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Torres-Macho Juan</a>, <a href="/search?value1=Jorge+Valencia&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Valencia Jorge</a>, <a href="/search?value1=Matilde+Sanchez-Conde&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sanchez-Conde Matilde</a></span>. HIV-infected Latin American asylum seekers in Madrid, Spain, 2022: A prospective cohort study from a major gateway in Europe. <a href="/content/ecdc">Euro Surveill.</a> 2024;29(29):pii=2300692. <a href="https://doi.org/10.2807/1560-7917.ES.2024.29.29.2300692" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2024.29.29.2300692</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 02 Dec 2023;&nbsp;&nbsp; <span class="generated">Accepted</span>: 28 Apr 2024 </span> </p>
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