HIV testing uptake, enablers, and barriers among African migrants in China: A nationwide cross-sectional study

Sexual health challenges in migrant, immigrant, and displaced populations 2022-2023

PURPOSE OF REVIEW

This article reviews recently published research on sexual health challenges and HIV and sexually transmitted infections (STIs) among migrant, immigrant and displaced people (MIDP) worldwide. We aimed to identify current evidence gaps regarding HIV/STI epidemiology, sexual health needs and interventions.

RECENT FINDINGS

Incidence and prevalence of HIV, hepatitis B virus, hepatitis C virus and syphilis were higher among MIDP compared to host populations. However, research studies are limited in geographical distribution and few routine surveillance data are collected. Barriers to sexual health services use and participation in preventive interventions include low HIV/STI symptom knowledge and risk awareness, and intersectional experiences of stigma/discrimination. Better targeted promotion messages are needed to increase utilization of preventive sexual health interventions.

SUMMARY

Access to, and use of, sexual health services and interventions are evident needs among MIDP. These needs are intertwined with social determinants of health, including cultural/language barriers and stigma. Effective interventions require involvement of multiple stakeholder groups, encouraging engagement and providing social protection. Promising directions for interventions and further research include developing sexual health supportive environments through peer-strategies and provider training in trauma-informed care.

Access to HIV/STI testing among male and female Venezuelan migrants in Peru: evidence from a nationwide survey

BACKGROUND

Human immunodeficiency virus (HIV) infection and sexually transmitted infections (STIs) are major global public health issues. Migrants represent a vulnerable group that faces multiple barriers to access to healthcare services, including HIV/STI testing. This study aimed to assess the factors associated with access to HIV/STI testing in male and female Venezuelan migrants in Peru.

METHODS

This was a cross-sectional study involving secondary data analysis of the 2022 Venezuelan Population Residing in Peru Survey. The study was conducted in the eight most populated cities inhabited by Venezuelan migrants and refugees. For each city, the sampling design was probabilistic, stratified, and independent. The outcome variable was whether participants had access to HIV or other STI testing during their stay in Peru. Statistical analysis was stratified by sex owing to potential effect modification. Crude and adjusted prevalence ratios were calculated using generalized linear models Poisson family with log link function. Confidence intervals were calculated to 95%.

RESULTS

A total of 3,723 male and 3,984 female migrants were included. Access to HIV/STI testing among male and female migrants was 19.85% and 25.16%, respectively. Among male migrants, being LGBTI, health insured, and married or cohabiting were associated with increased access to HIV/STI testing. Among females, those aged 18-44 years, those who were married or cohabiting and were health insured, and those residing for more than 1 year in Peru were significantly more likely to have access to HIV/STI testing. Moreover, physical/mental disability and unemployed status were associated with a lower probability of HIV/STI testing in females.

CONCLUSIONS

Only two in ten Venezuelan migrants and refugees in Peru were screened for HIV/STI, with fewer males than females. Sex-specific sociodemographic, health-related, and migration-related variables were independently associated with access to HIV/STI testing.

HIV testing among immigrant men who have sex with men in Brazil

OBJECTIVE

To evaluate the prevalence of non-testing for HIV among immigrant men who have sex with men (MSM) residing in Brazil and identify associated factors.

DESIGN

An analytical web-survey study was conducted across all Brazilian states from January 2020 to May 2021.

SAMPLE

The study included 804 MSM immigrants from Portuguese-speaking countries.

MEASUREMENTS

Odds ratio (OR) and adjusted Odds Ratio (AOR) were utilized to determine the strength of the association between non-HIV testing and associated factors.

RESULTS

Among the participants, 63.7% had never undergone HIV testing. Multivariate analysis revealed several factors associated with a higher likelihood of not being tested for HIV: having a steady/monogamus partner (AOR: 1.5; 95%CI: 1.1-2.3) or both casual and steady partners (AOR: 1.8; 95%CI: 1.2-3.4), not engaging in bareback sex (AOR: 1.91; 95%CI: 3-3.5), being an immigrant in the country for less than 12 months (AOR: 3.7; 95%CI: 2.5-9.7), and having a preference for insertive (AOR: 1.5; 95%CI: 1.1-2.5) or receptive (AOR: 2.9; 95%CI: 1.4-5.7) roles. However, practicing chemsex was found to be a protective factor for testing (AOR: 4).

CONCLUSION

To enhance HIV prevention strategies, it is crucial to implement specific measures that ensure accessibility, confidentiality, and a reduction in stigma associated with HIV testing.

HIV/STD prevalence and test uptake among african in Guangzhou, China: an analysis of data from hospital-based surveillance

Human immunodeficiency virus (HIV) and sexually transmitted diseases (STDs) cause substantial morbidity and mortality both in African and China. However, there is limited data available on the prevalence of HIV/STDs and the uptake of testing experience ever during in China among African migrants. A venue-based survey was conducted at a tertiary hospital in Guangzhou to investigate the prevalence of HIV/STDs through laboratory testing and identify the associated factors. A total of 200 eligible participants completed the survey and bring into the analysis from April to October 2019, and the temporary visitors were excluded. The prevalence rates of HIV, syphilis, NG, CT, and HBsAg among the participants were 1.0%, 2.5%, 1.0%, 1.5%, and 5.5%, respectively. The overall reported rate of HIV/STD testing was 37.0%, with rates of 23.0% for HIV, 16.5% for syphilis, 12.5% for NG, 6.5% for genital herpes, 5.0% for condyloma acuminata, and 2.5% for CT. HIV/STD testing was associated with living environment in Guangzhou, having medical insurance in China, and utilizing health services in China in the past year. HIV/STDs are prevalent among Africans in Guangzhou, and the epidemic is likely to spread due to a significant proportion of unprotected sexual behaviors and low rates of HIV/STD testing. Urgent interventions, including targeted health education, promotion of health service utilization, and active surveillance of HIV/STDs, are needed to reduce the risk of HIV/STD transmission.