Refugees and family-reunified immigrants have a high incidence of HIV diagnosis and late presentation compared with Danish born: a nationwide register-based cohort study
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Migrants represent a considerable proportion of HIV diagnoses in Europe and are considered a group at risk of late presentation. This study examined the incidence of HIV diagnoses and the risk of late presentation according to migrant status, ethnic origin and duration of residence.
We conducted a historically prospective cohort study comprising all adult migrants to Denmark between 1.1.1993 and 31.12.2010 (n = 114.282), matched 1:6 to Danish born by age and sex. HIV diagnoses were retrieved from the National Surveillance Register and differences in incidence were assessed by Cox regression model. Differences in late presentation were assessed by logistic regression.
Both refugees (HR = 5.61; 95% CI 4.45–7.07) and family-reunified immigrants (HR = 10.48; 95% CI 8.88–12.36) had higher incidence of HIV diagnoses compared with Danish born and the incidence remained high over time of residence for both groups. Migrants from all regions, except Western Asia and North Africa, had higher incidence than Danish born. Late presentation was more common among refugees (OR = 1.87; 95% CI 1.07–3.26) and family-reunified immigrants (OR = 2.30; 95% CI 1.49–3.55) compared with Danish born. Southeast Asia and Sub-Saharan Africa were the only regions with a higher risk of late presentation. Late presentation was only higher for refugees within 1 year of residence, whereas it remained higher within 10 years of residence for family-reunified immigrants.
This register-based study revealed a higher incidence of HIV diagnoses and late presentation among migrants compared with Danish born and the incidence remained surprisingly high over time.
KeywordsMigrants Ethnic minority Refugee HIV infection Late presentation
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
The project was approved by the Danish Protection Agency (No 2012-41-0065). Further ethical approval regarding registry-based research is not required in Denmark. The data set was made available and analysed in an anonymous form by remote online access to the data set stored at Statistics Denmark.
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