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Bromberg DJ, Tate MM, Alaei K, Karimov S, Saidi D, Alaei A. Predictors of Late Presentation for HIV among HIV-positive Tajik Migrants to the Russian Federation. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Between 800 thousand and 1.2 million citizens of Tajikistan currently live in the Russian Federation, one of the only countries where the HIV epidemic continues to worsen. Given the previously reported barriers to healthcare access for migrants in to the Russian Federation, and the rapidly expanding HIV epidemic in Eastern Europe and Central Asia, this present study set out to determine whether these barriers impact late presentation with HIV upon their return to Tajikistan. This study uses data from the Tajikistan Ministry of Health surveillance system. The dataset contains all new known HIV diagnoses between 2006 and 2018. At time of diagnosis, patients are interviewed by staff of AIDS centers, complete routine intake forms and complete medical exam and related forms by doctors. HIV-positive returned migrants who had lived in the Russian Federation (n = 770) were included in final data-analysis after data cleaning. Data were analyzed using three logistic (logit) models. The unadjusted logistic model found that for every year spent in the Russian Federation, the risk of late presentation for an HIV-positive Tajikistani migrant increases by 10.3% (95% CI: 5.5-15.3). The saturated multivariate model showed that when holding all study variables constant, the risk of late presentation for an HIV-positive Tajikistani migrant increases by 9.5% (95% CI: 2.6-16.9). The parsimonious multivariate model showed that when current age and region of origin are held constant, the risk of late presentation for an HIV-positive Tajikistani migrant increases by 6.3 (95% CI: 1.1-11.8). Even when other potential predictors are included in the logistic model, only age and length of time abroad remain statistically significant. The results of this paper suggest that if the Russian Federation were to adopt a reciprocal policy, it might improve treatment outcomes of migrant laborers. Further research is needed to explicate the causal pathways of the associations found in the present analysis.
Key messages
Structural factors are the strongest predictors of HIV late presentation among returned Tajik migrants to the Russian Federation. Further research is needed to explicate the causal pathways of the associations found in the present analysis.
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Affiliation(s)
- D J Bromberg
- Department of Social and Behavioral Sciences, Yale University, New Haven, Connecticut, USA
- Center for Interdisciplinary Research on AIDS (CIRA), Yale University, New Haven, Connecticut, USA
| | - M M Tate
- Yale University, New Haven, Connecticut, USA
| | - K Alaei
- Institute for International Health and Education, Albany, NY, USA
- School of Public Health, Drexel University, Philadelphia, PA, USA
| | - S Karimov
- Republican AIDS Center, Tajikistan Ministry of Health, Dushanbe, Tajikistan
| | - D Saidi
- Republican AIDS Center, Tajikistan Ministry of Health, Dushanbe, Tajikistan
| | - A Alaei
- Institute for International Health and Education, Albany, NY, USA
- Republican AIDS Center, Tajikistan Ministry of Health, Dushanbe, Tajikistan
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