The potential of routine surveillance data for identifying the needs of people living with HIV among migrants

Since the start of Russia’s war against Ukraine, more than one million people from Ukraine – a country with high Human Immunodeficiency Virus (HIV)-prevalence – have fled to Germany. We aimed to estimate the number of people living with HIV (PLHIV) with a link to Ukraine reported to the German HIV notification system, analyse their characteristics and estimate the proportion of prior known infections to better understand the care needs of this population. We descriptively analysed HIV surveillance data from 2001 to 2023 regarding links to Ukraine. We further characterised HIV notifications received between March 2022 and December 2023 with either a link to Ukraine or Germany in terms of reported transmission routes, age and gender distributions. We estimated the proportions of prior known and probably prior known diagnoses based on notifier comments, reported CD4 cell count and viral load measurements. We found a steep increase in Ukraine-linked notifications starting in March 2022, with yearly proportions reaching 19.7% in 2022 and 13.1% in 2023, compared to only 0.2%-1.6% in previous years. Among PLHIV from Ukraine, most were female (60%), and the majority of adult cases reported heterosexual transmission (74%). In contrast, notifications linked to Germany predominantly involved men who have sex with men (MSM) (45%). Compared to notifications about PLHIV linked to Germany, those about PLHIV associated to Ukraine showed a higher proportion of children (5% vs. 2%) – the majority of whom were infected through pre- and perinatal transmission (89%). The majority of PLHIV from Ukraine had either prior known or probably prior known diagnoses (53% of adults, 75% of children). Thus, PLHIV from Ukraine differ in their characteristics from those linked to Germany and consequently in their needs regarding HIV prevention and care services. They require rapid access to healthcare structures in Germany to ensure continuity of treatment. Our findings highlight the importance of considering migrant and refugee populations within Germany’s national HIV strategies, which are currently focused primarily on MSM. While our results demonstrate the overall usefulness of HIV surveillance data for characterising migrant populations, they also call for improvements in data quality and completeness

Biostatistics · Context (archaeology · German · Human immunodeficiency virus (HIV · Men who have sex with men · Public health · Refugee · Transmission (telecommunications · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Sex work and related issues · Epidemiology

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