Olivia Borchmann[1], Lars H. Omland[2], Jan Gerstoft[2], Carsten S. Larsen[3], Isik S. Johansen[4], Suzanne Lunding[5], Janne Jensen[6], Niels Obel[2], Ann-Brit E. Hansen[1]

Affiliates

Department of Infectious Diseases, Copenhagen University Hospital, 2650 Hvidovre, Denmark[1], Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark[2], Department of Infectious Diseases, Aarhus University Hospital, 8200 Aarhus, Denmark[3], Department of Infectious Diseases, Odense University Hospital, 5000 Odense, Denmark[4], Department of Internal Medicine, Herlev University Hospital, 2730 Herlev, Denmark[5], Department of Internal Medicine, Kolding Hospital, 6000 Kolding, Denmark[6]

Abstract

Background: Migrants face an increased risk of HIV infection and late presentation for HIV care. We aimed to examine delay in HIV diagnosis, linkage to HIV care, and risk of late presentation for migrants living with HIV in Denmark.
Methods: We conducted a population-based, nationwide study of adult migrants (n = 2166) presenting for HIV care between January 1, 1995 and December 31, 2020 in Denmark. Time from immigration to HIV diagnosis and from HIV diagnosis to linkage to care, and late presentation were assessed using descriptive statistics.
Results: The demographics of the migrant population changed over time. Migrants diagnosed with HIV after immigration to Denmark had resided a median of 3.7 (IQR 0.8-10.2) years in Denmark before HIV diagnosis. Median time from HIV diagnosis to linkage to care was 6 (IQR 0-24) days. Migrants diagnosed with HIV infection prior to immigration had a median of 38 (IQR 0-105) days from arrival in Denmark to linkage to care. The corresponding median times for 2015-2020 alone were 4.1 (IQR 0.9-13.1) years, 0 (IQR 0-8) days, and 62 (25-152) days. The overall proportion of late presentation among migrants diagnosed with HIV after immigration was 60%, and highest among migrants from Sub-Saharan Africa and East and South Asia.
Conclusions: HIV diagnosis is still substantially delayed in Danish migrants, while linkage to care is timely. The proportions with late presentation are high. These results call for targeted interventions to reduce the number of migrants with undiagnosed HIV infections and the number of late presenters.

(Accepted for publication in Eurosurveillance 28.04.2022, but not published)