Background Ethnic minorities originating from countries with high HIV prevalence account for a large number of heterosexually acquired HIV infections in Western European countries. These groups 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 infection in heterosexual partnerships between African migrants, Caribbean migrants, and the local Dutch population. Acquiring HIV infection before migrating to the Netherlands or during trips to the country of origin was also accounted for in the model.
Results The estimated HIV incidence 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 the change among the local 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 groups will increase; among the other ethnic groups, the increase will be very small.
Conclusions Changes in patterns of migration can have a considerable impact on HIV transmission within ethnic minority communities in the Netherlands, but they hardly have any impact on transmission in the local population. Therefore, 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 HIV disease in migrant communities.
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