HIV prevalence ratio of international migrants compared to their native-born counterparts: A systematic review and meta-analysis

Background: People on the move, including international migrants, may face health inequities that expose them to a higher risk for HIV than native-born populations. We conducted a systematic review to calculate the HIV prevalence ratio of international migrants compared with native-born populations.

Methods: We searched five databases between January 2010 and March 2022. Using random-effects meta-analysis, we calculated the pooled HIV prevalence ratios (PR) by comparing the HIV prevalence of migrants with native-born populations. Our research protocol is registered in the International prospective register of systematic reviews (PROSPERO, CRD42021250867).

Findings: In total, 5,121 studies were screened, and 38 were included in the final analysis: 7,121,699 migrants and more than 270 million natives were included in the analysis. The pooled PR for any foreign-born migrants was 1.70 (95% CI 1·11–2·61, I² =99.67%, n = 33 studies), refugees was 2.37 (95% CI 0.33–16.99, I² =99·5%, n = 5), undocumented people was 3.98 (95% CI 0·11–143.01, I² =94.6%, n = 3), whilst asylum seekers was 54.79 (95% CI 17.23–174.23, I² =90·2%, n = 2). Meta-regression revealed that population type (adjusted R-squared 11.5%), region of origin (11.3%) and migrant type (10.8%) accounted for heterogeneity more than country-income (2.4%) and study setting (2.3%).

Interpretation: Although it was not possible to assess if HIV infection occurred in the country of origin or destination, the HIV prevalence ratio was higher among migrants than in native-born populations. Inclusive health policies and strategies for delivering HIV testing, prevention and treatment services for migrant populations tailored to their needs are urgently needed.

• Epidemiology and Determinants of Health
  • Epidemiology
• Population(s)
  • Immigrants/Refugees/Non-status
  • General HIV+ population