When Athens saw HIV incidence begin to climb steeply in 2011, a familiar pattern emerged — the rate of new infections among migrants was disproportionate, and migrants were also likelier to be diagnosed later. To researchers who had tracked HIV impacts among migrants across Europe, this wasn’t surprising, authors of a report in Clinical Infectious Diseases note. While policies on paper reflect an acknowledgement that migrants face risks making them a priority population for HIV prevention and care, in reality, the barriers between people who have migrated from other countries and those services remain numerous and significant, they write.
With an eye to inform and improve HIV service access to migrants, the authors, led by Dimitrios Paraskevis of the University of Athens, analyzed data from a molecular investigation of the outbreak from 2011 to 2014 to pinpoint risks among migrants using injecting drugs. The overwhelming majority of HIV infections among migrants, they found, originated in Greece, indicating the severe impacts of the city’s ongoing outbreak on new arrivals. In addition they found that transmissions occurred most frequently from contacts between migrants. This reflected, the authors write, a tendency across populations to take more protective measures when dealing with “strangers,” than when among people with whom they share circumstances.
The findings also demonstrate the need and the impact of improved access to opioid substitution therapy, programs providing sterile needles and syringes, and HIV testing and treatment among migrants, the authors conclude. In addition, they write, the information gleaned from the research highlight the potential of molecular analysis to not only trace infections to their country of origin, but to detect patterns of transmission.