Autore: Massimiliano Lanzafame, U.O. Malattie infettive, Ospedale S. Chiara, Azienda per i servizi sanitari di Trento
donatella.visentin@apss.tn.it
Giovanni Mori, U.O. Malattie infettive, Ospedale S. Chiara, Azienda per i servizi sanitari di Trento, Università Vita-Salute San Raffaele, Milano; Emanuela Lattuada, U.O. Malattie infettive, Ospedale S. Chiara, Azienda per i servizi sanitari di Trento; Donatella Visentin, U.O. Igiene e sanità pubblica, Dipartimento di prevenzione, Azienda per i servizi sanitari di Trento; Luisa Carraro, U.O. Igiene e sanità pubblica, Dipartimento di prevenzione, Azienda per i servizi sanitari di Trento; Pirous Fateh -Moghadam, Servizio Osservatorio epidemiologico, Dipartimento di prevenzione, Azienda per i servizi sanitari di Trento; Maria Grazia Zuccali, Dipartimento di Prevenzione, Azienda per i servizi sanitari di Trento.
Categoria Primaria: Salute dei migranti, richiedenti asilo e rifugiati
Categoria Secondaria: Promozione della salute e prevenzione
INTRODUZIONE In Europe migrants have accounted for about 40% of new HIV diagnoses in Europe in 2022. Migrants living with HIV may face numerous intersecting stigmas related to their HIV and migration status, as well as broader racial and cultural discrimination. Overall, migrants in Italy are from countries with different seroprevalence and HIV subtypes rates and reach Italy by different migration routes. Before the implementation of the program, screening for HIV infection was poorly carried out among asylum seekers in Trentino for a number of reasons.
OBIETTIVI In this context, the Infectious Diseases Unit and the Prevention Department of the Azienda Provinciale per i Servizi Sanitari (APSS) implemented an HIV awareness, information, and screening program aimed at asylum seekers and operators of the reception facility in Trento, with the objective to contribute to the emergence of unknown cases and the reduction of late presenters which are goals set by PNAIDS 2017-2019.
METODI Rapid HIV self-testing was offered (OraQuick HIV self-test; Meridian Bioscience Europe s.r.l.), after an information and awareness intervention translated simultaneously by specially trained personal directly at the reception facilities. Rapid tests have the advantage of providing the result within minutes. In case of an preliminarily positive result, the protocol establishes that the person has to be accompanied by an operator to the Infectious Diseases Unit where the HIV antibody/antigen combination test can be immediately performed, ensuring that he or she would be taken into care as soon as possible in case of a positive test result.
RISULTATI The program was carried out between June and December 2023. 60 migrants (out of about 250 residents at the center) agreed to perform HIV self-test after a full explanation about the type of screening by an infectious diseases specialist. All were of male gender and presumably heterosexual. The mean age was 31 years (range 18-66 years). 62% of them came from Pakistan, 25% from Morocco and another 4% from Bangladesh. All HIV self-tests were nonreactive. Our results reflect the overall low prevalence rate of HIV infections in the countries of origin and highlight the importance to mitigate the risk of acquiring HIV after arrival.
CONCLUSIONI It was possible to implement a HIV screening program targeted at newly arrived migrants. Given the low prevalence rate, screening newly arrived migrants at the point of entry alone may not be sufficient in order to control HIV infections, also in consideration of the elevated risk of post-migration infection. The screening program should therefore continue to be integrated with health education interventions and the distribution of condoms. In regard of early detection of cases further efforts should be made to include also female refugees, at higher risk for being victims of sexual violence. The screening program of asylum seekers will be continued in 2024.