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The effectiveness and cost-effectiveness of screening for HIV in migrants in the EU/EEA

2018-08-09Recensão Acesso aberto
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dc.contributor.authorPottie, Kevin
dc.contributor.authorLotfi, Tamara
dc.contributor.authorKilzar, Lama
dc.contributor.authorHoweiss, Pamela
dc.contributor.authorRizk, Nesrine
dc.contributor.authorAkl, Elie A
dc.contributor.authorDias, Sonia
dc.contributor.authorBiggs, Beverly-Ann
dc.contributor.authorChristensen, Robin
dc.contributor.authorRahman, Prinon
dc.contributor.authorMagwood, Olivia
dc.contributor.authorTran, Anh
dc.contributor.authorRowbotham, Nick
dc.contributor.authorPharris, Anastasia
dc.contributor.authorNoori, Teymur
dc.contributor.authorPareek, Manish
dc.contributor.authorMorton, Rachael
dc.contributor.institutionEscola Nacional de Saúde Pública (ENSP)
dc.contributor.institutionCentro de Investigação em Saúde Pública (CISP/PHRC)
dc.contributor.pblMolecular Diversity Preservation International (MDPI)
dc.date.accessioned2018-12-03T23:19:34Z
dc.date.available2018-12-03T23:19:34Z
dc.date.issued2018-08-09
dc.description.abstractMigrants, defined as individuals who move from their country of origin to another, account for 40% of newly-diagnosed cases of human immunodeficiency virus (HIV) in the European Union/European Economic Area (EU/EEA). Populations at high risk for HIV include migrants, from countries or living in neighbourhoods where HIV is prevalent, and those participating in high risk behaviour. These migrants are at risk of low CD4 counts at diagnosis, increased morbidity, mortality, and onward transmission. The aim of this systematic review is to evaluate the effectiveness and cost-effectiveness of HIV testing strategies in migrant populations and to estimate their effect on testing uptake, mortality, and resource requirements. Following a systematic overview, we included four systematic reviews on the effectiveness of strategies in non-migrant populations and inferred their effect on migrant populations, as well as eight individual studies on cost-effectiveness/resource requirements. We assessed the certainty of our results using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. The systematic reviews reported that HIV tests are highly accurate (rapid test >90% sensitivity, Western blot and ELISA >99% sensitivity). A meta-analysis showed that rapid testing approaches improve the access and uptake of testing (risk ratio = 2.95, 95% CI: 1.69 to 5.16), and were associated with a lower incidence of HIV in the middle-aged women subgroup among marginalised populations at a high risk of HIV exposure and HIV related stigma. Economic evidence on rapid counselling and testing identified strategic advantages with rapid tests. In conclusion, community-based rapid testing programmes may have the potential to improve uptake of HIV testing among migrant populations across a range of EU/EEA settings.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent23
dc.format.extent1753895
dc.identifier.doi10.3390/ijerph15081700
dc.identifier.issn1660-4601
dc.identifier.otherPURE: 6510144
dc.identifier.otherPURE UUID: 117c1a02-c23b-4fde-82d9-01c25f7eef48
dc.identifier.otherPubMed: 30096905
dc.identifier.otherPubMedCentral: PMC6121945
dc.identifier.otherWOS: 000443168200140
dc.identifier.otherScopus: 85051400310
dc.identifier.urihttp://hdl.handle.net/10362/53589
dc.language.isoeng
dc.peerreviewedyes
dc.subjectSDG 3 - Good Health and Well-being
dc.titleThe effectiveness and cost-effectiveness of screening for HIV in migrants in the EU/EEAen
dc.title.subtitlea systematic reviewen
dc.typereview
degois.publication.issue8
degois.publication.titleInternational Journal of Environmental Research and Public Health
degois.publication.volume15
dspace.entity.typePublication
rcaap.rightsopenAccess

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