How patterns of migration can influence the heterosexual transmission of HIV in the Netherlands
Résumé
Objectives. Migrants originating from countries with high HIV prevalence account for a large number of heterosexually acquired HIV infections in Western European countries. These migrants may be infected before migrating and they may engage in unsafe sexual practices both in the country of residence and in their country of origin. We investigate how patterns of migration may affect the heterosexual HIV epidemic in the Netherlands. Methods. A mathematical model was used that describes the transmission of HIV in heterosexual partnerships between African migrants, Caribbean migrants, and the local Dutch population. Infection of migrants before migrating to the Netherlands and during trips to their country of origin was also accounted for. Results. The incidence of HIV infection among adult heterosexuals in 2010 was 1.50 new infections per 100,000 individuals per year. If the number of migrants entering the country increases, then the incidence of HIV will increase, although this change among Dutch will be negligible. Moreover, if HIV prevalence among those migrating to the Netherlands (at the time of entry to the country) is higher, then the incidence in the respective ethnic group will increase; among the other ethnic groups, the increase will be very small. Conclusions. Heterosexual transmission of HIV in the Netherlands occurs mostly within migrant communities. Limiting migration and introducing travel restrictions would likely have no effect on HIV incidence in countries with low HIV prevalence among heterosexuals. Policy making should focus on targeted interventions, to reduce the burden of disease in migrant communities in Europe.
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