HIV prevalence, sexual risk behaviour and sexual mixing patterns among migrants in Amsterdam, The Netherlands.

OBJECTIVE To study (1) HIV prevalence; (2) sexual risk behaviour; (3) sexual mixing patterns; (4) determinants of disassortative (between-group) mixing among migrant groups in Amsterdam, the Netherlands and to gain insight into the potential for heterosexual spread of HIV/sexually transmitted diseases. DESIGN Cross-sectional study among 1660 Surinamese, Antilleans and sub-Saharan Africans, mainly recruited on the streets. METHODS Saliva was tested for HIV and questions were asked about sociodemographic characteristics, sexual behaviour and the ethnicity of sexual partners. Multivariate logistic regression analysis was used to find predictors for disassortative mixing. RESULTS HIV prevalence was 1.1% (95% confidence interval: 0.6-1.7). Compared with the Dutch population in general, our study group reported having multiple partners, concurrent partnerships and a history of sexually transmitted diseases much more frequently. Sex in the country of origin during a visit occurred frequently and there was a considerable degree of sexual mixing between different ethnic groups in the Netherlands. For men, disassortative mixing was associated with hard drug use, recent immigration, a high number of partners, being from Nigerian or Hindu-Surinamese origin, a recent sexually transmitted disease and, for steady relationships, consistent condom use. For women, determinants included: hard drug use, low income, being a-religious and, for Antillean and Ghanaian women, consistent condom use. CONCLUSION Our data suggest a potential for heterosexual spread of sexually transmitted diseases within and between ethnic groups in the Netherlands. The potential for HIV spread is however limited by the low HIV prevalence at present among these groups. This situation may change when HIV prevalence increases in the countries of origin, as bridges exist between those countries and the Netherlands. Culturally appropriate AIDS prevention programmes remain important for these groups.

[1]  R. Coutinho,et al.  [Opportunistic screening for genital infections with Chlamydia trachomatis among the sexually active population of Amsterdam. Il Over 90% participation and almost 5% prevalence]. , 1999, Nederlands tijdschrift voor geneeskunde.

[2]  R. Coutinho,et al.  HIV surveillance among sexually transmitted disease clinic attenders in Amsterdam, 1991–1996 , 1998, AIDS (London).

[3]  A E Ades,et al.  Epidemiology and detection of HIV-1 among pregnant women in the United Kingdom: results from national surveillance 1988-96 , 1998, BMJ.

[4]  Y. V. van Duynhoven,et al.  Different demographic and sexual correlates for chlamydial infection and gonorrhoea in Rotterdam. , 1997, International journal of epidemiology.

[5]  D. Carrington,et al.  Prevalence of HIV-1 infection among heterosexual men and women attending genitourinary clinics in Scotland: unlinked anonymous testing , 1997, BMJ.

[6]  M. Kretzschmar,et al.  Concurrent partnerships and the spread of HIV , 1997, AIDS.

[7]  A. Ghani,et al.  The Role of Sexual Partnership Networks in the Epidemiology of Gonorrhea , 1997, Sexually transmitted diseases.

[8]  P. Bindels,et al.  RESULTATEN VAN DE SCREENING OP HIV-ANTISTOFFEN BIJ ZWANGERE VROUWEN IN DE AMSTERDAMSE PEILSTATIONS, 1988-1995 , 1996 .

[9]  R. Rothenberg,et al.  Commentary: The Relevance of Social Network Concepts to Sexually Transmitted Disease Control , 1996, Sexually transmitted diseases.

[10]  B. Christenson,et al.  The Epidemiology of Human Immunodeficiency Virus and Other Sexually Transmitted Diseases in the Stockholm Area , 1995, Sexually transmitted diseases.

[11]  R. May,et al.  Networks of sexual contacts: implications for the pattern of spread of HIV , 1989, AIDS.

[12]  S. Zeger,et al.  Longitudinal data analysis using generalized linear models , 1986 .

[13]  K Y Liang,et al.  Longitudinal data analysis for discrete and continuous outcomes. , 1986, Biometrics.

[14]  P. Bindels,et al.  Aids-epidemie in Nederland: recente ontwikkelingen naar transmissieroute , 1997 .

[15]  S. Aral.  Heterosexual transmission of HIV: the role of other sexually transmitted infections and behavior in its epidemiology prevention and control. , 1993, Annual review of public health.

[16]  S. Gupta,et al.  The significance of sexual partner contact networks for the transmission dynamics of HIV. , 1990, Journal of acquired immune deficiency syndromes.