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Migrants travelling to their country of origin: a bridge population for HIV transmission?
  1. M A Kramer1,
  2. M G van Veen2,
  3. E L M Op de Coul2,
  4. R B Geskus1,3,
  5. R A Coutinho2,4,5,
  6. M J W van de Laar2,6,
  7. M Prins1,4,5
  1. 1
    Cluster Infectious Diseases, Amsterdam Health Service, Amsterdam, The Netherlands
  2. 2
    Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
  3. 3
    Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
  4. 4
    Center for Infection and Immunity Amsterdam, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
  5. 5
    Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
  6. 6
    European Centre for Disease Prevention and Control, Stockholm, Sweden
  1. M A Kramer, Department of Research, Cluster Infectious Diseases, Health Service of Amsterdam, PO Box 2200, 1000 CE Amsterdam, The Netherlands; mkramer{at}


Background: By having unprotected heterosexual contact in both The Netherlands and their homeland, migrants who travel to their homeland might form a bridge population for HIV and sexually transmitted infection (STI) transmission. We studied the determinants for such a population in two large migrant communities in The Netherlands.

Methods: From 2003 to 2005, 1938 people of Surinamese and Antillean origin were recruited at social venues in two large cities, interviewed and their saliva samples tested for HIV antibodies. We used multivariate multinomial logistic regression to explore characteristics of groups with four risk levels (no, low, moderate and high) for cross-border transmission.

Results: 1159/1938 (60%) participants had travelled from The Netherlands to their homeland in the previous 5 years and 1092 (94%) of them reported partnerships and condom use in both countries. Of these 9.2% reported having unprotected sex with partners in both countries. People in this high-risk or bridge population group were more likely to be male, frequent travellers and older compared with people who had no sex or had sexual contact solely in one country in the past 5 years.

Conclusions: Older male travellers of Surinamese and Antillean origin are at high risk for cross-border heterosexual transmission of HIV/STIs. They should be targeted by prevention programmes, which are focused on sexual health education and HIV/STI testing, to raise their risk awareness and prevent transmission.

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  • Funding: The study was supported by a grant from the AIDS Foundation, The Netherlands (grant no 7015).

  • Competing interests: None declared.

  • Contributors: EC, RC, ML and MP participated in the design of the study, obtaining funding and supervision. MK and MV managed the field work, testing of samples and the data. MK analysed the data. RG provided statistical support. All authors contributed to the final version of this paper.