Accès ouvert déclaré2025article
Risk of new HIV diagnosis by intersecting migration, socioeconomic, and mental health vulnerabilities in the Netherlands: a nationwide analysis of the ATHENA cohort and Statistics Netherlands registry data
Vita W. Jongen, Anders Boyd, Patrizia Carrieri, Nina Schat, Selwyn H. Lowe, Rosan van Zoest, Jolanda Lammers, Mark D. Verhagen, Ard van Sighem, Marije K. Bomers, Godelieve J. de Bree, Suzanne E. Geerlings, Abraham Goorhuis, Victoria Harris, Joppe W. Hovius, Bregtje A. Lemkes, Edgar J.G. Peters, T. van der Poll, Jan M. Prins, Kim Sigaloff, V. Spoorenberg, Michèle van Vugt, W. Joost Wiersinga, C. Bruins, J. van Eden, I.J. Hylkema-van den Bout, Liedewij Laan, F J J Pijnappel, S Smalhout, M E Spelbrink, Robin van Houdt, Marcel Jonges, Martijn van der Kuip, Dasja Pajkrt, Fleur Hessing, Marcel van den Berge, Arjan Stegeman, S. Baas, L. Hage de Looff, Andreas van Arkel, Jiřı́ Stöhr, Bas Wintermans, M.J.H. Pronk, Heidi Ammerlaan, E.S. de Munnik, S. Phaf, Birgit Deiman, Volkher Scharnhorst, M.C.A. Wegdam, Jeannine F. Nellen, Arne van Eeden, Elske Hoornenborg, Sacha de Stoppelaar, H. Berends, L. Elsenburg, H. Nobel, Katja C. Wolthers, Nicole Back, M.E.E. van Kasteren, Marvin A. H. Berrevoets, Annemarie E. Brouwer, Andrew L. Adams, B.A.F.M. de Kruijf-van de Wiel, M. Pauwels-van Rijkevoorsel, J.L. Murck, Casper Rokx, Adam A. Anas, Hannelore I. Bax, Eric C. M. Van Gorp, Martim Melo, Els van Nood, Jan Nouwen, Bart Rijnders, Carolina A. M. Schurink, Lennert Slobbe, T.E.M.S. de Vries-Sluijs, N. Bassant, J.E.A. van Beek, M. Vriesde, L.M. van Zonneveld, Joris R. de Groot, Jeroen J. A. van Kampen, Marion Koopmans, Pieter L. A. Fraaij, Annemarie M. C. van Rossum, Clementien L. Vermont, Linda C. van der Knaap, Judith Branger, Reuben Douma, A.S. Cents-Bosma, M.A. Mulder, Emile F. Schippers, Charlotte de Bree, Cees van Nieuwkoop, J. Geilings, A. van Overeem, G. van der Hut, Nathalie D. van Burgel, Eliane M.S. Leyten, L. B. S. Gelinck, Femke Mollema, M. Langbein, G.S. Wildenbeest, T. H. Nguyen, B. Hafkamp, J.W. Bouwhuis, A.J.J. Lammers, A. G. W. van Hulzen, S. Kraan, S.B. Debast, Gertjan H.J. Wagenvoort, Anna H.E. Roukens, Mark de Boer, H. Jolink, Merel M. C. Lambregts, Henk Scheper, A. Metselaar, D. van der Sluis, Sophie Boers, Eric C. J. Claas, Els Wessels, Jan G. den Hollander, Rachida el Moussaoui, Katalin Pogány, C.J. Brouwer, D. Heida-Peters, Emma R. Mulder, Jesper Smit, D. Struik-Kalkman, T.G.C.M. van Niekerk, Carla van Tienen, S.H. Lowe, Astrid M. L. Oude Lashof, Dirk Posthouwer, Annerieke Stoop, Marlies E van Wolfswinkel, Robin Ackens, M. Elasri, K. Houben-Pintaric, J. Schippers, Thomas Havenith, Inge H. M. van Loo, Linda M. Kampschreur, Sonja E. van Roeden, Michelle Broekhuizen, A. Al Moujahid, G. J. Kootstra, Corine Delsing, Matthijs Plas, L. Scheiberlich, W. Kortmann, G. van Twillert, R. Renckens, Jiri F. P. Wagenaar, D. Ruiter-Pronk, Barend Jacobus Stander, J. W. T. Cohen Stuart, Marieke Hoogewerf, Wouter Rozemeijer, J. C. Sinnige, Kees Brinkman, G.E.L. van den Berk, Kamilla D. Lettinga, Marina de Regt, W.E.M. Schouten, Janneke E. Stalenhoef, S.M.E. Vrouenraets, H. Blaauw, G.F. Geerders, M.J. Kleene, M. Knapen, Marjolein Kok, I.B. van der Meché, A.J.M. Toonen, S. Wijnands, E. Wttewaal, David Kwa, Thijs van de Laar, Reinout van Crevel, Koen van Aerde, Rob J.W. Arts, Stefanie Henriet, H.J.M. ter Hofstede, Jacobien J. Hoogerwerf, Olivier Richel, Kim Stol, M. Albers, K.J.T. Grintjes-Huisman, M. de Haan, M. Marneef, Matthew B. B. McCall, Janette Rahamat‐Langendoen, Esmée Ruizendaal, David M. Burger, Elisabeth H. Gisolf, Mark A. A. Claassen, R.J. Hassing, G. ter Beest, P.H.M. van Bentum, Y. Neijland, M. Valette, C.M.A. Swanink, M. Klein Velderman, S.F.L. van Lelyveld, Robert Soetekouw, L.M.M. van der Prijt, J. van der Swaluw, Jayant Kalpoe, Alex Wagemakers, A. Vahidnia, Fanny N. Lauw, D.W.M. Verhagen, Michiel P. van Wijk, Wouter F.W. Bierman, Margreet Bakker, Johanneke Kleinnijenhuis, E. Kloeze, Ananja Middel, Douwe F. Postma, Ymkje Stienstra, Marjan Wouthuyzen‐Bakker, André Boonstra, M.M.M. Maerman, D.A. de Weerd, B.R. Brandsema, Aline R. Verhage, N. van der Woude, Tatiana Mudrikova, Roos E. Barth, A.H.W. Bruns, Pauline M. Ellerbroek, M.P.M. Hensgens, Jan Jelrik Oosterheert, E.M. Schadd, Annelies Verbon, Berend J. van Welzen, B.M.G. Griffioen-van Santen, L. van de Koolwijk, Yvette G.T. Loeffen, E. O. W. Rooijakkers, D. van de Wetering, André Justino Alberto, S Zaheri, Daniela Bezemer, A.I. van Sighem, Colette Smit, M Hillebregt, T. Rutkens, J.M. Grolleman, L.E. Koster, S.T. van Loenen, Maartje Schoorl, Kirsten Visser, M. van den Akker, O.M. Akpomukai, Richard B. Alexander, Y. Bakker, Luciana Solera Sales, A el Berkaoui, M. Bezemer-Goedhart, Claire Bon, E.A. Djoechro, I. el Hammoud, M.R. Khouw, C.R.E. Lodewijk, E.G.A. Lucas, S. van Meerveld-Derks, M.A. van Montfoort, H. Mulder, L. Munjishvili, C.M.J. Ree, A.F. van Rijk, P.P. Schnörr, R. van Veen, D.P. Bergsma, Y.M.C. Ruijs-Tiggelman
1Citations signalées
14Institutions associées
3Pays d’affiliation
Résumé fourni par la source
Background: To further reduce new HIV diagnoses in the Netherlands, individual and structural barriers hindering prevention must be addressed. We aimed to estimate the disproportional burden of new HIV diagnoses and explore how intersecting socio-demographic, socio-economic, and health-related factors jointly influence the risk of a new HIV diagnosis. Methods: We combined data from the ATHENA cohort, an ongoing nationwide HIV cohort, with registry data from Statistics Netherlands. We selected individuals with a new HIV diagnosis between 1 January 2012 and 31 December 2023 and matched them to individuals from the general population. We assessed determinants of a new HIV diagnosis using a multivariable generalized linear model. We used Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) to quantify the joint and individual contribution of intersecting variables. Findings: 6055 men and 1020 women were newly diagnosed with HIV. Having a migration background and a low to middle income or income below the poverty line was associated with a higher risk of a new HIV diagnosis for both men (low to middle: adjusted odd ratio (aOR) = 1.24, 95% confidence interval (CI) = 1.17-1.31; below the poverty line: aOR = 1.75, 95% CI = 1.62-1.89) and women (low to middle: aOR = 2.49, 95% CI = 2.05-3.01; below the poverty line: aOR = 4.71, 95% CI = 3.80-5.83). Use of mental health care (aOR = 1.14, 95% CI = 1.01-1.27) or antidepressants (aOR = 1.66, 95% CI = 1.50-1.84) also increased the risk among men; while receiving social welfare (aOR = 1.39, 95% CI = 1.15-1.67) and use of antipsychotic medication (aOR = 1.66, 95% CI = 1.21-2.28) increased the risk among women. Of all intersections identified in MAIHDA, men with a first-generation migration background, income below the poverty line, and who used antidepressants had the highest predicted probability of an HIV diagnosis (0.036%, 95% confidence interval (CI) = 0.025-0.052). Women with a first-generation background, income below the poverty line, who received social welfare, and who used antipsychotic medication had the highest predicted risk (0.019%, 95% CI = 0.011-0.035). Interpretation: A disproportionally higher burden of a new HIV diagnosis was observed for individuals with a migration background and economic and mental health vulnerabilities. HIV prevention and testing need to be reinforced in these groups. Funding: Dutch Ministry of Health, Welfare and Sport; TKI Health Holland.
Sujets associés
HIV/AIDS Research and InterventionsAdolescent Sexual and Reproductive HealthHIV/AIDS Impact and Responses