ArticleBMC public health2019
Delayed linkage to HIV care among asylum seekers in Quebec, Canada.
Article in BMC public health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- Barriers and Facilitators Affecting the HIV Care Cascade for Migrant People Living with HIV in Organization for Economic Co-Operation and Development Countries: A Systematic Mixed Studies Review.AIDS patient care and STDs · 2021Pooled it
- Material deprivation and its correlates in treatment-naïve migrants with HIV with rapid access to B/F/TAF at no cost: A sub-study of the ASAP cohort.HIV medicine · 2026Article
- The risk of HIV and HCV transmission in Canadians living with coinfection before, during, and after the COVID pandemic: A prospective cohort study.Canadian journal of public health = Revue canadienne de sante publique · 2026Article
- Impact of mental health service use on the HIV care cascade among women.HIV medicine · 2025Article
- From theory to practice of designing for diversity: Applying intersectionality to improve HIV testing uptake.PloS one · 2025Article
- A Socio-Ecological Perspective on Linkage to HIV Care in Bandung, Indonesia: A Qualitative Study to Explore Barriers and Facilitators.Journal of multidisciplinary healthcare · 2025Article
- Healthcare Experiences and Service Delivery Gaps for Pregnant Women Living with HIV in Kiryandongo Settlement Camp, Northern Uganda.HIV/AIDS (Auckland, N.Z.) · 2025Article
- Mental health service use and shortages among a cohort of women living with HIV in Canada.BMC health services research · 2024Article
- HIV-infected Latin American asylum seekers in Madrid, Spain, 2022: A prospective cohort study from a major gateway in Europe.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2024Article
- Sexually Transmitted Infections Prevalence and Cascade of Care among Undocumented Sex Workers: A Twenty-Year-Long Experience.Life (Basel, Switzerland) · 2023Article
- HIV care cascade for women living with HIV in the Greater Toronto Area versus the rest of Ontario and Canada.International journal of STD & AIDS · 2023Article
- Late Diagnosis in HIV with New and Old Definitions; Data from a Regional Hospital in Turkey.International journal of general medicine · 2023Article
- Development of a Prototype for a Bilingual Patient-Reported Outcome Measure of the Important Health Aspects of Quality of Life in People Living with HIV: The Preference Based HIV Index (PB-HIV).Journal of personalized medicine · 2022Article
- Left behind on the path to 90-90-90: understanding and responding to HIV among displaced people.Journal of the International AIDS Society · 2022Article
- Experiences of Migrant People Living with HIV in a Multidisciplinary HIV Care Setting with Rapid B/F/TAF Initiation and Cost-Covered Treatment: The 'ASAP' Study.Journal of personalized medicine · 2022Article
- Length of stay in Denmark before HIV diagnosis and linkage to care: a population-based study of migrants living with HIV, Denmark, 1995 to 2020.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2022Article
- Phylogenetic Clustering among Asylum Seekers with New HIV-1 Diagnoses in Montreal, QC, Canada.Viruses · 2021Article
- Characteristics of new HIV diagnoses over 1995-2019: A clinic-based study in Montréal, Canada.PloS one · 2021Article
- Article
- Role of the pharmacist caring for people at risk of or living with HIV in Canada.Canadian pharmacists journal : CPJ = Revue des pharmaciens du Canada : RPCArticle
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMigrants represent an increasing proportion of people living with HIV in many developed countries. We aimed to describe the HIV care cascade and baseline genotypic resistance for newly diagnosed asylum seekers referred to the McGill University Health Centre (MUHC) in Montreal, Quebec, Canada.
methodsWe conducted a retrospective cohort study of patients linked to the MUHC from June 1, 2017 to October 31, 2018. We calculated the median time (days; interquartile range (IQR)) from: 1) entry into Canada to immigration medical examination (IME) (i.e. HIV screening); 2) IME to patient notification of diagnosis; 3) notification to linkage to HIV care (defined as a CD4 or viral load (VL) measure); 4) linkage to HIV care to combination antiretroviral therapy (cART) prescription; and 5) cART prescription to viral suppression (defined as a VL < 20 copies/mL). We reviewed baseline genotypes and interpreted mutations using the Stanford University HIV Drug Resistance Database. We calculated the proportion with full resistance to > 1 antiretroviral.
resultsOverall, 43% (60/139) of asylum seekers were newly diagnosed in Canada. Among these, 62% were late presenters (CD4 < 350 cells/μl), 22% presented with advanced HIV (CD4 < 200 cells/μl), and 25% with high-level viremia (VL > 100,000 copies/ml). Median time from entry to IME: 27 days [IQR:13;55]; IME to notification: 28 days [IQR:21;49]; notification to linkage: 6 days [IQR:2;19]; linkage to cART prescription: 11 days [IQR:6;17]; and cART to viral suppression: 42 days [IQR:31;88]; 45% were linked to HIV care within 30 days. One-fifth (21%) had baseline resistance to at least one antiretroviral agent; the K103 N/S mutation was the most common mutation.
conclusionsWhile the majority of newly diagnosed asylum seekers were late presenters, only 45% were linked to care within 30 days. Once linked, care and viral suppression were rapid. Delays in screening and linkage to care present increased risk for onward transmission, and in the context of 21% baseline resistance, consideration of point-of-care testing and immediate referral at IME screening should be made.
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