HIV-Infected Latin American Asylum Seekers in Europe: Insights From the EuroLatin HIV Cohort

Study Overview
=================
Brief Summary
-----------------
This is a longitudinal observational study conducted in Europe that describes migrants infected with HIV from Latin America who come to Europe with the intention of seeking asylum or international protection. The aim of the study is to identify the barriers this population faces in accessing the healthcare system and to assess disease control

Detailed Description
-----------------
Study Design and Setting This observational study was conducted between 2022 and 2023 in Madrid, Spain. Participants were recruited at the HIV outpatient clinic of Infanta Leonor University Hospital (HUIL) for the study and were monitored for a period of 6 months from their enrollment in the study. Participant Recruitment Participants were primarily identified and referred by various non-governmental organizations (NGOs) working with migrants living with HIV. These NGOs, which included gTt-VIH, Apoyo Positivo, Cogam, Acción Triangulo, Kif-Kif, Salud Entre Culturas, and the Spanish Red Cross, played an essential role by establishing a crucial link and provided a vital bridge, facilitating the patients' integration into the healthcare system through an unconventional circuit. Medical Evaluation In the HIV unit, assessments were conducted by experienced infectious disease specialists and a unit-specific nurse. The care protocol comprised a meticulous collection of medical history, an exhaustive physical examination, along with a series of tests. Furthermore, appointments were scheduled for a one-month and six-month follow-up to ensure continuous care and monitor the effectiveness of the treatment regimen. Social and Psychological Evaluation An experienced social worker with a background in vulnerable populations was hired to perform a social assessment. Six months post the initial hospital visit, the social worker re-established contact with the patients to reassess their social circumstances and their continued engagement with the HIV consultation services. Ethical Considerations This study adhered to the ethical principles outlined in the Declaration of Helsinki and received the necessary approvals from the ethics committee at Infanta Leonor Hospital. Informed consent was provided by every participant. Data collection In this study, the REDCap application was utilized for the collection of data. The database was stored in a secure server, and only researchers and health personnel of the project had access to it.

Official Title
-----------------
HIV-Infected Latin American Asylum Seekers in Europe: Insights From the EuroLatin HIV Cohort (ELHC)

Conditions
-----------------
HIV-1-infection, Sexually Transmitted Diseases

Intervention / Treatment
-----------------
* Other: Description


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Latin American migrants infected with HIV who arrive in Spain with the intent to seek international protection and who lack access to healthcare. Exclusion Criteria: Those who do not give their consent
Sexes Eligible for Study
-----------------
All

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| EuroLatin HIV Cohort (ELHC)<br>Cohort of Latin American migrants living with HIV who were seeking international protection in Spain (Europe) | Other: Description<br>* This study aimed to understand the situation of Latin American HIV-positive migrants seeking asylum in Spain and identify the challenges they encounter in getting HIV treatment. The main result measured was the proportion of participants with an HIV-1 RNA level of 50 copies/mL or higher at their first clinic visit<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| HIV viral control | Number of participants with plasma HIV-1 RNA level of more than 50 copies per mL | At inclusion | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Resistance Pattern | Number of participants with Drug Resistance | At inclusion | 
| Sexually transmited infections | Number of participants with sexually transmited infections | At inclusion | 
| Number and Type of Barriers to Accessing Healthcare | The outcome will assess the number and type of barriers faced by study participants when trying to access healthcare, based on the presence of any of the following barriers: administrative, geographical, financial, cultural, lack of knowledge, stigma, and organizational. | At inclusion | 
| HIV viral control at 6 months | Number of participants with plasma HIV-1 RNA level of more than 50 copies per mL | 6 months | 
| Retention in care | Number of participants who maintain retention to healthcare | 6 months | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Asylum Seekers, Migration, Europe, Latin America