Are Opportunities Being Missed? Burden of HIV, STI and TB, and Unawareness of HIV among African Migrants

Abstract

Sub-Saharan African migrants (SSAMs) have been disproportionately affected by infectious disease burden. We aimed to identify correlates of HIV, past sexually transmitted infection (STI) and past Tuberculosis infection (TB), as well as examine HIV seropositivity unawareness and testing history among SSAMs. A venue-based sample of 790 SSAMs completed a cross-sectional biobehavioral survey on sexual practices, HIV testing and self-reported infectious diseases; an HIV rapid test was offered. Overall, 5.4% of participants were HIV-positive and 16.7% reported a past STI. Odds of being HIV positive or having a past STI were higher among participants with low socioeconomic status and who experienced violence from a partner. Increased odds of having a past STI were also found among long-term migrants and those who reported sexual risk behaviors. In total, 4.1% of participants had TB in the past; these were more likely male and HIV positive. Unawareness of HIV-positive status was notably high (35%). Half of the participants had never been tested for HIV before, including over a third of those who had STI or TB in the past. Efforts are needed to reduce missed opportunities for HIV/STIs prevention and uptake of HIV testing among SSAMs through more integrated care, while addressing social determinants of infectious diseases.

‘I Didn’t Know Where to Go’: A Mixed-Methods Approach to Explore Migrants’ Perspectives of Access and Use of Health Services during the COVID-19 Pandemic

“…The literature shows that most migrant populations tend to have a good health status on arrival in the host country compared to the native populations, but this advantage can diminish over time as exposure to health risks increases [ 17 , 18 ]. Upon arrival in host countries, some groups of migrants face a new physical and social environment that, combined with fragile socioeconomic conditions, contributes to an increased vulnerability in health [ 18 ].…”

“…The literature shows that most migrant populations tend to have a good health status on arrival in the host country compared to the native populations, but this advantage can diminish over time as exposure to health risks increases [ 17 , 18 ]. Upon arrival in host countries, some groups of migrants face a new physical and social environment that, combined with fragile socioeconomic conditions, contributes to an increased vulnerability in health [ 18 ]. In addition, studies indicate that some groups tend to experience difficulties in accessing health services, especially those more socially vulnerable, such as recently arrived migrants and those without a regular migration status [ 18 , 19 , 20 , 21 , 22 , 23 , 24 ].…”

“…Upon arrival in host countries, some groups of migrants face a new physical and social environment that, combined with fragile socioeconomic conditions, contributes to an increased vulnerability in health [ 18 ]. In addition, studies indicate that some groups tend to experience difficulties in accessing health services, especially those more socially vulnerable, such as recently arrived migrants and those without a regular migration status [ 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. Cultural and linguistic differences, economic difficulties, lack of social support, stigma, and discrimination can also hamper access to available information and health care.…”

Reducing Sexual and Reproductive Health Inequities Between Natives and Migrants: A Delphi Consensus for Sustainable Cross-Cultural Healthcare Pathways

“…Previous studies have also highlighted the need for on-going monitoring of risk behaviors, STIs, and accessing services among migrant populations, as well as further research to help understand its intersecting inequities ( 89 ). It is important to identify key populations (including migrants) to be targeted with tailored HIV prevention activities and treatment options, as well as services that provide care and support based on the recipients' different backgrounds and needs ( 90 , 91 ). Regarding the Comprehensive education and information sub-dimension, the panel of experts endorsed the importance of the “ Number of people with levels of sexual health literacy considered adequate.” An adequate level of health literacy would contribute to making informed decisions, which contribute to an increase in migrants' health and empowerment ( 92 , 93 ).…”

Migrant Communities at the Center in Co-design of Health Literacy-Based Innovative Solutions for Non-communicable Diseases Prevention and Risk Reduction: Application of the OPtimising HEalth LIteracy and Access (Ophelia) Process

“…Migrants often face difficulties in accessing and using health services due to economic and legal constraints, lack of information about health rights and other individual, sociocultural, economic, administrative, and structural barriers (12,13). As a result, they often tend to be missed by conventional disease prevention and surveillance programmes, to not receive health information and health education targeted to the mainstream population and to have delayed access to diagnosis and care (10,(14)(15)(16). These avoidable determinants impact on NCD care, generating excess downstream public health services costs, worsening NCDs outcomes, and increasing disadvantage and poverty (10).…”