Disassortative sexual mixing among migrant populations in the Netherlands: a potential for HIV/STI transmission?

Abstract

To gain insight into the transmission of HIV and sexually transmitted infection (STI) among large migrant groups in The Netherlands, we studied the associations between their demographic and sexual characteristics, in particular condom use, and their sexual mixing patterns with other ethnic groups. In 2002-2005, cross-sectional surveys were conducted among migrants from Surinam (Afro- and Hindo-), the Netherlands Antilles, Cape Verde, and Ghana at social venues in three large cities. A questionnaire was administrated and a saliva sample was collected for HIV antibody testing. Of 2105 migrants recruited, 1680 reported sexual contacts, of whom 41% mixed sexually with other ethnicities, including the indigenous Dutch population. Such disassortative mixing was associated with being second-generation migrant, having several sexual partners, and having a steady and concurrent casual partner. Less disassortative mixing occurred in participants reporting visiting the country of origin. The association between condom use and sexual mixing differed by gender, with men using condoms inconsistently being most likely to be mixing with the Dutch indigenous population. HIV infection and recent STI treatment were not associated with disassortative mixing. This study shows substantial sexual mixing among migrant groups. Since disassortative mixing is more prevalent in second-generation migrants, it might increase in the upcoming years. The mixing patterns in relation to concurrency and the reported condom use in this study suggest a possibly increased level of HIV/STI transmission not only within migrant groups but also between migrant groups, especially via men who mix with the indigenous population and via migrant women who mix with non-Dutch casual partners. Although the observed HIV prevalence in migrants (0.6%) is probably too low to lead to much HIV transmission between ethnicity groups, targeted prevention measures are needed to prevent transmission of other STI.

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

“…SD: +++ V: +++ G: ++ OS: +++Data does not support some of the conclusions. Authors do not acknowledge limitations of surveillance data.van Veen et al (2009) [27] Sexual mixing: Partners from the same ethnicity 59 %, Partners with differing ethnicity 41 % (15 % with Dutch partners; 21 % with partners of “Other” ethnicity; 5 % with both Dutch and “Other”).SD: +++ V: +++ G: ++ OS: +++Desirability bias ; convenience sample; auto-selection bias.BA = Black African, BC = Black Caribbean, SSA = Sub Saharan African, SEP = Socioeconomic Position, MSM = Men who have sex with men SD = Study Design, V = Validity, G = Generalisability, OS = Overall Score, N/A = Not applicable…”

“…Elford et al (2007) [26] state that 80 % of black African heterosexuals reported sexual partners of the same ethnicity and van Veen et al (2009) [27] found that 41 % of their sample had partners with different ethnicity (15 % with Dutch partners). Similarly Marisciano et al (2013) reported that 50 % of men and 47 % of women had partners from a different country although most were from another African country [28].…”

‘Migrants fromover there’ or ‘racial minorityhere’? Sexual networks and prevention practices among sub-Saharan African migrants in France

“…Studies on sexual networks among migrants tend to have focused on sexual contact between migrants from countries with generalised HIV epidemics and native populations (Gras et al 1999(Gras et al , 2001Van Veen et al 2009;Wiggers et al 2003;Xiridou et al 2010) -the crucial question here being the potential epidemic spread from these groups to the so-called general population, with little attention being paid to sexual mixing between migrants from different sub-Saharan African countries. Our analyses provide evidence of the existence of African sexual networks, over and beyond national origin.…”

“…An over-representation of young, highly educated and recently arrived migrants While for reasons of feasibility, surveys among migrants tend to favour convenience sampling (Gras et al 1999;Sadler et al 2006;Van Veen et al 2009), this survey has relied on random recruitment (Lydié 2007;Lydié, Guilbert, and Sliman 2008). However, due to the overall low response rate, the sample may seem closer to a convenience sample.…”

“…Transformations in the patterning of the HIV epidemic in Europe have raised concerns about sexual mixing and HIV-preventive behaviours of migrants in receiving countries (Fenton et al 2005;Sadler et al 2007;Van Veen et al 2009. Migrants, especially from sub-Saharan Africa, continue to bear a disproportionate burden of HIV infections in many European countries (Del Amo et al 2009;Le Vu et al 2010;Onusida 2009).…”