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HIV infection and engagement in the care continuum among migrants and refugees from Venezuela in Colombia: a cross-sectional, biobehavioural survey
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7 2023
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Source: Lancet HIV. 10(7):e461-e471
[PDF-196.51 KB]
Details:
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Alternative Title:Lancet HIV
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Personal Author:
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Description:Background:
The crisis in Venezuela has produced one of the most significant human displacements in recent history. To inform HIV programming and treatment distribution, we aimed to estimate HIV prevalence and associated indicators among Venezuelan migrants and refugees residing in Colombia, the largest receiving country.
Methods:
We conducted a biobehavioral, cross-sectional survey using respondent-driven sampling among Venezuelan adults who arrived in Colombia since 2015 and resided in four cities, Bogotá, Soacha, Soledad, and Barranquilla. Participants completed socio-behavioral questionnaires and rapid HIV and syphilis screening with laboratory-based confirmatory testing, CD4 testing, and viral load quantification. Policies related to legal migration status affect access to insurance and HIV services in Colombia, as in many receiving countries; thus, we provided legal assistance and navigation support to participants with HIV for sustained access to treatment. Population-based estimates were weighted for the complex sampling design. Penalized multivariable logistic regression analysis was used to identify correlates of viral suppression (HIV RNA<1,000 copies/mL).
Findings:
Between July 30, 2021–February 5, 2022, 6,221 participants were enrolled. 71 participants (sample estimate: 1.1%) had laboratory-confirmed infection, resulting in a weighted population HIV prevalence of 0·9% (95%CI: 0·6–1·4). Among the sample living with HIV, 47·9% (34/71) were previously diagnosed and 35·2% (25/70) were virally suppressed. Individuals with irregular migration status (reference: regular; aOR:0·3, 95%CI: 0·1–0·9), and with a last HIV test in Colombia (reference: Venezuela; aOR:0·2, 95%CI: 0·1–0.8) were independently less likely to have suppressed viral loads.
Interpretation:
HIV prevalence among Venezuelan migrants and refugees in Colombia suggests the epidemic is close to a generalized stage, which may be addressed by inclusion of migrants and refugees in local HIV services, enhanced access to and navigation support for HIV testing and care, and coordination with humanitarian programs. There is a clear link between current legal migration status and viral suppression, conferring both clinical and epidemiological implications; thus, legal aid and access to insurance may support early detection and treatment for people with irregular migration status.
Funding:
PEPFAR through the Centers for Disease Control and Prevention
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Pubmed ID:37302399
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Pubmed Central ID:PMC10336726
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Volume:10
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Issue:7
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