Journal of Migration and Health最新文献_第10页

Health for all? A cost-utility evaluation of Colombia's policy to enroll Venezuelan migrants (2021–2023) 人人享有健康？哥伦比亚招收委内瑞拉移民政策的成本效用评估（2021-2023）

IF 2.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Journal of Migration and Health

Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100374

Oscar Espinosa , Paul Rodríguez , Valeria Bejarano , Santiago León , José Luis Ortiz

Introduction

From 2021 to 2023, Colombia implemented a national policy to expand health insurance coverage for over 1.4 million Venezuelan migrants through its subsidized health insurance system, which provides universal health coverage to low-income Colombian populations. This study evaluates the cost-utility of the intervention, focusing on its health and economic returns.

Methods

We conducted a cost-utility analysis by translating government expenditure per enrolled migrant into health outcomes (QALYs/YLLs) using Colombia-specific cost-effectiveness thresholds. Health benefits were measured in quality-adjusted life years (QALYs) gained and years of life lost (YLLs) averted. Colombia-specific cost-effectiveness thresholds (CETs) were used to estimate outcomes, and an internal rate of return (IRR) analysis assessed the program's social profitability.

Results

The intervention generated an estimated 10,259 QALYs gained or 11,843 YLLs averted between 2021 and 2023. The IRR reached 27.5% when QALYs were valued at 100% of Gross Domestic Product per capita, indicating strong social returns. Women and adults aged 19–44 showed the greatest health gains, with urban areas receiving the highest benefits. This evidence demonstrates that even health policies can yield high social returns, providing a model for other countries navigating large-scale migration.

Discussion

Expanding subsidized health insurance to migrants proves to be a highly cost-effective policy. This analysis supports Colombia’s approach as a scalable and impactful model for inclusive public health aligned with universal health coverage goals.

从2021年到2023年，哥伦比亚实施了一项国家政策，通过其补贴医疗保险制度扩大140多万委内瑞拉移民的医疗保险覆盖面，该制度为哥伦比亚低收入人口提供全民医疗保险。本研究评估了干预的成本效用，重点关注其健康和经济回报。方法采用哥伦比亚特有的成本-效果阈值，通过将每个登记移民的政府支出转化为健康结果（QALYs/YLLs），进行了成本-效用分析。健康益处以获得的质量调整生命年（QALYs）和避免的生命损失年（YLLs）来衡量。哥伦比亚特定的成本效益阈值（CETs）用于估计结果，内部收益率（IRR）分析评估了该计划的社会盈利能力。结果在2021年至2023年期间，干预产生了约10,259个QALYs或避免了11,843个ylys。当QALYs的价值达到人均国内生产总值的100%时，内部收益率达到27.5%，表明社会回报强劲。19-44岁的女性和成年人的健康状况改善最大，城市地区受益最大。这一证据表明，即使是卫生政策也能产生很高的社会回报，为其他应对大规模移民的国家提供了一个模式。扩大对移民的医疗保险补贴是一项极具成本效益的政策。这一分析支持哥伦比亚的做法是一种可扩展和有影响力的包容性公共卫生模式，与全民健康覆盖目标相一致。

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引用次数: 0

Beyond individual integration: Family systems, social support networks and living environment as health determinants among migrants in Germany 超越个人融合：家庭系统、社会支持网络和生活环境是德国移民健康的决定因素

IF 2.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Journal of Migration and Health

Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100368

Franziska Reinhardt, Imad Maatouk

While research has established links between migration and health outcomes, the role of cultural and social factors in mediating this relationship remains understudied. This study examines how family relationships, value orientations, and life satisfaction interact with migration status to influence health outcomes in Germany.

Using data from the Family Demographic Panel (FReDA), a representative German study on family relationships, we conducted multiple linear and multivariate regression analyses (n = 8939). The study employs a comprehensive set of health indicators, including both objective measures and self-reported health status.

The analyses reveal that migration status alone is not a significant predictor of health outcomes when controlling for social and cultural factors. Instead, life satisfaction and family relationships showed substantial effects on health. Both traditional and modern family values were linked to better health outcomes, showing that stable values, regardless of whether they are traditional or modern, can support health.

These findings challenge simplified assumptions about migration-health relationships and emphasize the importance of recognizing cultural values, social support systems, and psychosocial well-being as relevant factors in addressing health disparities. They also underscore the need for healthcare systems to adopt culturally sensitive approaches that consider the diverse social realities of individuals.

虽然研究确定了移徙与健康结果之间的联系，但文化和社会因素在调解这种关系方面的作用仍未得到充分研究。本研究考察了家庭关系、价值取向和生活满意度如何与移民身份相互作用，从而影响德国的健康结果。使用来自德国家庭关系代表性研究FReDA的数据，我们进行了多元线性和多元回归分析（n = 8939）。这项研究采用了一套全面的健康指标，包括客观测量和自我报告的健康状况。分析表明，在控制社会和文化因素的情况下，移民身份本身并不是健康结果的重要预测因素。相反，生活满意度和家庭关系对健康有实质性影响。传统和现代家庭价值观都与更好的健康结果有关，这表明稳定的价值观，无论是传统的还是现代的，都可以支持健康。这些发现挑战了关于移民与健康关系的简化假设，并强调了认识到文化价值观、社会支持系统和心理健康是解决健康差异的相关因素的重要性。他们还强调，卫生保健系统需要采取考虑个人不同社会现实的文化敏感方法。

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引用次数: 0

First-generation Turkish immigrants' views and preferences on cardiovascular disease prevention in primary care - a qualitative study in the Netherlands 第一代土耳其移民对初级保健中心血管疾病预防的看法和偏好——荷兰的一项定性研究

IF 2.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Journal of Migration and Health

Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100367

Joshua A.N. van Apeldoorn , Julie S. Jansen , Eva L. Liefhebber , Özgül Uysal-Bozkir , Edanur Sert , Ralf E. Harskamp , Charles Agyemang , Edo Richard , Eric P. Moll van Charante

Objectives

First-generation Turkish migrants in the Netherlands face higher cardiovascular risk and are disproportionately affected by cardiovascular disease (CVD) compared to the Dutch host population. To improve prevention in primary care, we explored their views and preferences on cardiovascular prevention.

Design

We conducted a qualitative study by interviewing first-generation Turkish migrants in The Netherlands. Semi-structured interviews and focus groups, conducted in Dutch or Turkish, were analyzed using thematic analysis.

Results

We conducted 26 individual interviews and two sex-stratified focus group sessions. Participants were aware of CVD risk factors and related health hazards but struggled to adopt a healthy lifestyle, as family obligations, household responsibilities, and work often took precedence over personal health. All participants identified language barriers as a significant challenge, but opinions varied on whether it was necessary for GPs to understand Turkish culture. Some felt this was unnecessary, viewing GPs primarily as medical decision-makers or intermediaries for referrals to other (para)medics, with lifestyle advice outside their professional scope. They emphasized that GPs should ask openly about lifestyle rather than assuming that behaviours associated with a Turkish cultural background play a role.

Conclusions

First-generation Turkish migrants in the Netherlands were aware of CVD risk, but personal responsibilities posed challenges in adopting a healthy lifestyle. Although views on the importance of GPs understanding Turkish culture varied, participants agreed that GPs should ask openly about lifestyle rather than assuming cultural relevance in cardiovascular prevention.

目的：与荷兰移民相比，荷兰的第一代土耳其移民面临更高的心血管疾病风险，且心血管疾病（CVD）的发病率不成比例。为了提高初级保健的预防水平，我们探讨了他们对心血管疾病预防的看法和偏好。DesignWe通过采访在荷兰的第一代土耳其移民进行了一项定性研究。用荷兰语或土耳其语进行的半结构化访谈和焦点小组使用主题分析进行了分析。结果我们进行了26次个人访谈和2次性别分层焦点小组会议。参与者意识到心血管疾病的风险因素和相关的健康危害，但很难采取健康的生活方式，因为家庭义务、家庭责任和工作往往优先于个人健康。所有参与者都认为语言障碍是一个重大挑战，但对于全科医生是否有必要了解土耳其文化，意见不一。有些人认为这是不必要的，他们认为全科医生主要是医疗决策者或转诊给其他（para）医生的中介，他们的专业范围之外有生活方式方面的建议。他们强调，全科医生应该公开询问生活方式，而不是假设与土耳其文化背景相关的行为起作用。结论荷兰的第一代土耳其移民意识到心血管疾病的风险，但个人责任对采取健康的生活方式提出了挑战。尽管对全科医生了解土耳其文化的重要性的看法各不相同，但与会者一致认为全科医生应该公开询问生活方式，而不是假设心血管预防与文化相关。

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引用次数: 0

Unequal weathering: How immigrants’ health advantage vanishes over the life-course 不平等风化：移民的健康优势如何在一生中消失

IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Journal of Migration and Health

Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100303

Silvia Loi , Peng Li , Mikko Myrskylä

The weathering hypothesis implies that there is an interaction between age and race or ethnicity that results in marginalized groups experiencing a more rapid decline in health than the dominant groups. This hypothesis has been tested mostly focusing on racial and ethnic health inequalities, while less is known about weathering by immigration background. This paper aims at contributing to this strand of research by addressing four research questions: is the health of immigrants declining at a faster pace over the life-course, compared to non-immigrants? Do higher levels of education protect immigrants from accelerated ageing compared to non-immigrants? How do income and marital status affect the health trajectories of immigrants and non-immigrants? How do these patterns vary by sex? We use longitudinal survey data to estimate healthy ageing trajectories of immigrants and non-immigrants over the life-course, in the German context. We examine the roles of education, income, and marital status, separately for men and women. We find that immigrants, and especially immigrant women, have a faster health decline than non-immigrants; that high education is linked to higher levels of health, but does not protect immigrants from ageing in poorer health compared to non-immigrants; and that health disparities between immigrants and non-immigrants persist over the life-course net of the socio-economic controls, which appear to be secondary to other unobserved determinants.

风化假说认为，年龄与种族或族裔之间存在相互作用，导致边缘群体的健康状况比优势群体下降得更快。这一假设主要集中在种族和民族健康不平等方面进行了测试，而对移民背景的风化作用知之甚少。本文旨在通过解决四个研究问题来促进这一研究链：与非移民相比，移民的健康状况在整个生命过程中是否以更快的速度下降？与非移民相比，更高的教育水平能保护移民免受加速老龄化的影响吗？收入和婚姻状况如何影响移民和非移民的健康轨迹？这些模式如何因性别而异？在德国的背景下，我们使用纵向调查数据来估计移民和非移民在整个生命过程中的健康老龄化轨迹。我们分别考察了教育、收入和婚姻状况对男性和女性的影响。我们发现，移民，尤其是移民妇女，健康状况下降的速度比非移民更快；高等教育与较高的健康水平有关，但并不能保护移民不因健康状况较差而老龄化；移民和非移民之间的健康差异持续存在于社会经济控制的生命历程中，这似乎是次要的，而其他未被观察到的决定因素。

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引用次数: 0

Breastfeeding practices and exclusive breastfeeding among syrian refugee mothers in Jordanian Host Communities 约旦收容社区叙利亚难民母亲的母乳喂养做法和纯母乳喂养

IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Journal of Migration and Health

Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100324

Suhaila Halasa , Reema Safadi , Dua' Al-Maharma , Manar Nabolsi , Jennifer Dohrn , Muayyad Ahmad

Breastfeeding initiation and exclusivity are essential in reducing maternal and neonatal mortality and morbidity rates. Employing the Health Belief Model as a framework, this cross-sectional survey aimed to identify influencing factors and barriers to exclusive breastfeeding among 523 eligible Syrian refugee mothers living in Jordan. Of these, 35.8 % practiced exclusive breastfeeding and 36.9 % initiated breastfeeding within the first hour of birth. The logistic regression model showed that prior breastfeeding experience (OR = 5.06, p < 0.001, 95 % CI: 2.17–11.82), maternal satisfaction with feeding method (OR = 3.58, p < 0.001, 95 % CI: 1.89–6.76), medical insurance (OR = 1.74, p = 0.015, 95 % CI: 1.11–2.73), birth method (OR = 1.69, p = 0.034, 95 % CI: 1.04–2.73) and infant gender (OR= 0.64, p = 0.05, 95 % CI: 0.41–0.99) significantly influenced exclusive breastfeeding rates.

The findings revealed that breastfeeding practices do not align with WHO recommendations, emphasizing the crucial role of healthcare providers in supporting breastfeeding mothers during crises. It is essential to consider the unique circumstances and cultural backgrounds of refugees when evaluating their needs for developing breastfeeding programs. International health organizations, like the UNHCR, and host country policymakers should prioritize access to antenatal and postnatal counseling services and health insurance for mothers and children during crises.

母乳喂养的开始和专一性对于降低孕产妇和新生儿死亡率和发病率至关重要。采用健康信念模型作为框架，这项横断面调查旨在确定生活在约旦的523名符合条件的叙利亚难民母亲纯母乳喂养的影响因素和障碍。其中，35.8%实行纯母乳喂养，36.9%在出生后一小时内开始母乳喂养。logistic回归模型显示，既往母乳喂养经历(OR = 5.06, p <；0.001, 95% CI: 2.17-11.82)，产妇对喂养方式的满意度(OR = 3.58, p <；0.001, 95% CI: 1.89-6.76)、医疗保险（OR= 1.74, p = 0.015, 95% CI: 1.11-2.73）、分娩方法（OR= 1.69, p = 0.034, 95% CI: 1.04-2.73）和婴儿性别（OR= 0.64, p = 0.05, 95% CI: 0.41-0.99）显著影响纯母乳喂养率。调查结果显示，母乳喂养做法不符合世卫组织的建议，强调了卫生保健提供者在危机期间支持母乳喂养母亲方面的关键作用。在评估难民制定母乳喂养计划的需求时，必须考虑他们的独特情况和文化背景。难民署等国际卫生组织和东道国决策者应优先考虑在危机期间为母亲和儿童提供产前和产后咨询服务和健康保险。

{"title":"Breastfeeding practices and exclusive breastfeeding among syrian refugee mothers in Jordanian Host Communities","authors":"Suhaila Halasa , Reema Safadi , Dua' Al-Maharma , Manar Nabolsi , Jennifer Dohrn , Muayyad Ahmad","doi":"10.1016/j.jmh.2025.100324","DOIUrl":"10.1016/j.jmh.2025.100324","url":null,"abstract":"<div><div>Breastfeeding initiation and exclusivity are essential in reducing maternal and neonatal mortality and morbidity rates. Employing the Health Belief Model as a framework, this cross-sectional survey aimed to identify influencing factors and barriers to exclusive breastfeeding among 523 eligible Syrian refugee mothers living in Jordan. Of these, 35.8 % practiced exclusive breastfeeding and 36.9 % initiated breastfeeding within the first hour of birth. The logistic regression model showed that prior breastfeeding experience (OR = 5.06, <em>p</em> < 0.001, 95 % CI: 2.17–11.82), maternal satisfaction with feeding method (OR = 3.58, <em>p</em> < 0.001, 95 % CI: 1.89–6.76), medical insurance (OR = 1.74, <em>p</em> = 0.015, 95 % CI: 1.11–2.73), birth method (OR = 1.69, <em>p</em> = 0.034, 95 % CI: 1.04–2.73) and infant gender (OR= 0.64, <em>p</em> = 0.05, 95 % CI: 0.41–0.99) significantly influenced exclusive breastfeeding rates.</div><div>The findings revealed that breastfeeding practices do not align with WHO recommendations, emphasizing the crucial role of healthcare providers in supporting breastfeeding mothers during crises. It is essential to consider the unique circumstances and cultural backgrounds of refugees when evaluating their needs for developing breastfeeding programs. International health organizations, like the UNHCR, and host country policymakers should prioritize access to antenatal and postnatal counseling services and health insurance for mothers and children during crises.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"11 ","pages":"Article 100324"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Exploring health literacy among Japanese and international university students in Japan: A comparative cross-sectional study 日本大学生与国际大学生健康素养探讨：一项比较横断面研究

IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Journal of Migration and Health

Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100334

Akindele Abimibayo Adeoya

Objective

Health literacy (HL) is the ability to access, understand, evaluate, and apply health information for well-being. However, comparisons between domestic and international students remain limited. This study aims to investigate HL among Japanese and international university students in Japan and explore the factors that influence it.

Methods

This cross-sectional study used both the English and Japanese versions of the 47-item European Health Literacy Survey Questionnaire (HLS-EU-Q47). Using convenience sampling, a total of 1366 university students across six regions in Japan who provided informed consent participated in this self-administered, online-based survey. Descriptive statistics, t-tests, ANOVA and multiple regression were conducted as appropriate at a 0.05 alpha level using JMP statistical software (version 17.0.0)

Results

The results revealed that 60 % and 32 % of participants had inadequate and problematic HL, respectively, indicating that 92 % of all students had limited HL. International students exhibited better HL than Japanese university students (p < 0.0001), a difference that remained after adjusting for sociodemographic and educational factors (β = 3.39, 95 % confidence interval = 2.83 – 3.95, p < 0.0001). The competency of “appraising” within the healthcare domain presented the greatest challenge for international students, whereas “understanding” within the disease prevention domain was most difficult for Japanese students. Furthermore, the results indicated a strong association between HL and sociodemographic factors such as age, level of study, marital status, and religious affiliation. In contrast, health literacy showed an inverse association with economic status, program of study and parental education level. There was an observable trend between improved Japanese language proficiency and improved HL among international students.

Conclusion

International students in Japan demonstrated better HL than Japanese university students. Educational institutions must take a more proactive role in fostering HL for all students through general health education and peer-to-peer programs to create a more informed, healthy, and productive student community.

目的健康素养（HL）是获取、理解、评估和应用健康信息的能力。然而，国内学生和国际学生之间的比较仍然有限。本研究旨在调查日本和在日留学生的HL，并探讨影响HL的因素。方法本横断面研究采用英文和日文两种版本的欧洲健康素养调查问卷（HLS-EU-Q47）。采用方便抽样，日本六个地区共有1366名提供知情同意的大学生参加了这项自我管理的在线调查。采用JMP统计软件（17.0.0版），在0.05 alpha水平下进行描述性统计、t检验、方差分析和多元回归分析。结果结果显示，60%和32%的参与者分别患有不充分的HL和有问题的HL，表明92%的学生患有有限的HL。国际学生比日本大学生表现出更好的HL (p <；0.0001)，在调整社会人口统计学和教育因素后仍然存在差异(β = 3.39, 95%置信区间= 2.83 - 3.95,p <；0.0001)。对国际学生来说，保健领域的“评价”能力是最大的挑战，而对日本学生来说，疾病预防领域的“理解”能力是最困难的。此外，研究结果表明，HL与年龄、学习水平、婚姻状况和宗教信仰等社会人口因素有很强的相关性。健康素养与经济状况、学习计划、父母教育程度呈负相关。国际学生日语水平的提高与语言能力的提高之间存在显著的趋势。结论在日留学生的HL表现优于日本大学生。教育机构必须通过普通健康教育和点对点项目，在培养所有学生的HL方面发挥更积极的作用，以创造一个更知情、更健康、更有成效的学生社区。

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引用次数: 0

Infectious disease research in forcibly displaced populations: A systematic review in low- and middle-income host countries 被迫流离失所人口的传染病研究：在低收入和中等收入东道国的系统审查

IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Journal of Migration and Health

Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100341

Neila Gross , Maia C. Tarnas , Rashmina J. Sayeeda , Carly Ching , David Flynn , Muhammad H Zaman

Background

Infectious disease research is essential for disease prevention and management within refugee camps and informal settlements. The objective of this study is to identify the characteristics of existing infectious disease research in these settings and to assess stated research challenges, ethical considerations, and studied interventions within these studies.

Methods

This is a systematic review of forty primary studies focused on infectious disease research conducted among displaced populations. Included studies are published in English between 1995 and 2023. Three databases were searched, PubMed, Embase, and Web of Science, and this review was registered with PROSPERO (CRD42023461567). The risk of bias of the studies was assessed using the Mixed Methods Appraisal Tool.

Results

85 % of studies (n = 34) researched an intervention for infectious disease prevention or control and 70 % of studies (n = 28) were randomized controlled trials. 75 % of studies were located in Bangladesh (n = 15) or Pakistan (n = 15). 40 % of studies focused on diarrheal diseases (n = 16) and 28 % on malaria (n = 11). Common identified research challenges included population mobility, limited external validity, and low recruitment. No studies included the community in the initial study conception or investigated the research impact on the community. Community involvement was often through community health workers (45 %). Of the 18 studies that studied a resource-based intervention, 20 % explicitly noted that the intervention was unsustainable.

Discussion

While guidelines for conducting research in displaced settings exist, there are gaps in their utilization. We identified a disconnect between where displaced individuals reside and where research is conducted, as well as a prioritization of particular infectious diseases. Researchers identified numerous challenges in conducting research in these settings, though the community was rarely involved in the research. Context-specific considerations and community involvement are vital in research with displaced communities.

Funding

Wellcome Trust (Contract Number C-010,656).

背景：传染病研究对难民营和非正式住区内的疾病预防和管理至关重要。本研究的目的是确定这些环境中现有传染病研究的特征，并评估这些研究中所述的研究挑战、伦理考虑和研究干预措施。方法系统回顾了在流离失所人群中进行的传染病研究的40项主要研究。纳入的研究在1995年至2023年间以英文发表。检索PubMed、Embase和Web of Science三个数据库，并在PROSPERO注册（CRD42023461567）。使用混合方法评估工具评估研究的偏倚风险。结果85% （n = 34）的研究为传染病预防或控制的干预措施，70% （n = 28）的研究为随机对照试验。75%的研究位于孟加拉国（n = 15）或巴基斯坦（n = 15）。40%的研究侧重于腹泻病（n = 16）， 28%侧重于疟疾（n = 11）。常见的研究挑战包括人口流动、有限的外部有效性和低招募率。没有研究将社区纳入最初的研究概念或调查研究对社区的影响。社区参与往往是通过社区卫生工作者进行的（45%）。在研究基于资源的干预措施的18项研究中，20%明确指出干预措施是不可持续的。讨论虽然存在在流离失所环境中进行研究的指导方针，但在使用方面存在差距。我们发现流离失所者的居住地与开展研究的地点之间存在脱节，并确定了特定传染病的优先次序。研究人员确定了在这些环境中进行研究的许多挑战，尽管社区很少参与研究。具体情况的考虑和社区参与对流离失所社区的研究至关重要。资助威康信托（合同编号C-010,656）。

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引用次数: 0

Rate estimation and trend analysis of new HIV infections among the international migrant population in Chile from 2013 to 2022 2013 - 2022年智利国际移民人口艾滋病新发感染率估算及趋势分析

IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Journal of Migration and Health

Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2024.100297

Rodrigo Puentes , María Alejandra Dünner , Natalia T. Santis-Alay , Mario E. Soto-Marchant , Cecilia Canales , Janepsy Díaz

Background

International migrants are central to HIV research, but comparative data on their infection rates versus resident populations, including in Chile, are scarce. This study compares HIV incidence rates between international migrants and Chileans.

Methods

A longitudinal study was conducted. Crude and standardized rates of new HIV infections reported by the Institute of Public Health of Chile (ISP) were calculated for the period 2013 to 2022, using data from public and private health facilities nationwide. Population estimates for international migrants and Chileans were obtained from the National Institute of Statistics (INE) and the National Migration Service (SERMIG). Rates were adjusted for age and sex using the direct method.

Results

A total of 51,513 validated new HIV infections were analyzed, of which 14,936 (29.0 %) occurred in international migrants and 36,577 (71.0 %) in Chileans. International migrants showed an increase in incidence rates between 2013 and 2022 (adjusted rate from 22.6 [95 % CI: 18.3 – 27.0] to 115.6 [95 % CI: 110.5 – 120.7] new HIV infections per 100,000 population). Throughout the study period, the ratio of adjusted incidence rates between international migrants and Chileans increased from 1.0 [95 % CI: 0.9 – 1.2] to 7.6 [95 % CI: 7.2 – 8.0].

Conclusions

HIV incidence rates were higher in international migrants than in Chileans and increased over the study period. This may be influenced by various exogenous factors, including social determinants of health and the COVID-19 pandemic. It is crucial to focus on HIV diagnosis, prevention, and control strategies for international migrants in Chile.

背景：国际移民是艾滋病毒研究的核心，但关于其感染率与常住人口（包括智利）的比较数据很少。这项研究比较了国际移民和智利人之间的艾滋病发病率。方法：采用纵向研究。智利公共卫生研究所（ISP）报告的2013年至2022年期间艾滋病毒新发感染率和标准化感染率是根据全国公共和私营卫生机构的数据计算出来的。国际移徙者和智利人的人口估计数来自国家统计局和国家移徙服务局。使用直接法根据年龄和性别调整比率。结果：共分析了51,513例HIV新发感染病例，其中国际移民14936例（29.0%），智利人36577例（71.0%）。2013年至2022年期间，国际移民的发病率有所上升（调整后的比率从每10万人新增艾滋病毒感染22.6例[95% CI: 18.3 - 27.0]增至115.6例[95% CI: 110.5 - 120.7]）。在整个研究期间，国际移民和智利人之间的调整发病率之比从1.0 [95% CI: 0.9 - 1.2]增加到7.6 [95% CI: 7.2 - 8.0]。结论：国际移民的艾滋病毒感染率高于智利人，并且在研究期间呈上升趋势。这可能受到各种外部因素的影响，包括健康的社会决定因素和COVID-19大流行。重点关注智利国际移民的艾滋病毒诊断、预防和控制策略至关重要。

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引用次数: 0

Posttraumatic stress among refugees: The moderating effect of perceived social support 难民创伤后压力：感知社会支持的调节作用

IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Journal of Migration and Health

Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100323

Victoria Sophie Boettcher, Frank Neuner

Objective

Social support has been associated with the mental health of refugees. However, little is known about the characteristics and effects of social support in this group. The aim of this study was to investigate the protective role of social support, specifically through the perceived opportunity to confide in someone. We hypothesized that the opportunity to confide would have a moderating influence on the dose-effect relationship between trauma exposure and PTSD symptoms.

Methods

Clinical face-to-face interviews were conducted with 65 adult refugees who were living in the north-east of North Rhine-Westphalia. Interpreters (Arabic, Farsi, Kurmancî) were present if necessary. Interviews included a detailed assessment of traumatic event types, PTSD symptoms (assessed via the PTSD Checklist for DSM-5 (PCL-5)), and social support experienced by the participants.

Results

The multiple hierarchical regression analysis revealed a significant moderation of the perceived opportunity to confide on the association of number of traumatic event types reported and PTSD symptomatology. For refugees with limited trauma exposure, opportunity to confide was associated with lower PTSD symptoms. Most confidants were located within the countries of reception, while contacts in the home countries were less often identified as protective.

Conclusions

Social support, in particular the opportunity to confide, seems to act as a buffering factor up to a certain number of experienced traumatic event types. Specialized interventions may be necessary for people with a high trauma load and / or high symptom level.

目的社会支持与难民的心理健康密切相关。然而，人们对这一群体中社会支持的特征和影响知之甚少。这项研究的目的是调查社会支持的保护作用，特别是通过感知到的向某人倾诉的机会。我们假设，在创伤暴露和创伤后应激障碍症状之间的剂量效应关系中，吐露心事的机会会起到调节作用。方法对居住在北莱茵-威斯特伐利亚州东北部的65名成年难民进行临床面对面访谈。口译员（阿拉伯语、波斯语、Kurmancî）在必要时在场。访谈包括对创伤事件类型、创伤后应激障碍症状（通过DSM-5 （PCL-5）的创伤后应激障碍检查表进行评估）和参与者所经历的社会支持的详细评估。结果多层次回归分析显示，创伤性事件类型数量与创伤后应激障碍症状之间的关系对感知机会有显著的调节作用。对于创伤暴露有限的难民来说，倾诉的机会与较低的创伤后应激障碍症状有关。大多数知己都在接待国境内，而在母国的接触较少被认定为保护。社会支持，特别是倾诉的机会，似乎在一定数量的创伤性事件类型中起着缓冲作用。对于高创伤负荷和/或高症状水平的人，可能需要专门的干预措施。

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引用次数: 0

Perspectives of migrant men who have sex with men and professionals on personal, social and structural barriers and facilitators to sexual healthcare access and outreach strategies: A qualitative study 与男性发生性关系的移徙男子和专业人员对个人、社会和结构障碍以及性保健获取和外展战略的促进因素的看法：一项定性研究

IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Journal of Migration and Health

Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100342

Chrissy PB Moonen , Christian JPA Hoebe , Casper DJ den Heijer , Jill Buursma , Marita ILS Werner , Ymke J Evers , Nicole HTM Dukers-Muijrers

Background

Migrant men who have sex with men (mMSM) carry a disproportionate burden of sexually transmitted infections (STIs) yet encounter unique barriers to accessing sexual healthcare. This qualitative study explored mMSM’s and professionals’ perspectives regarding mMSM’s personal, social and structural barriers and facilitators to Dutch sexual healthcare access and outreach strategies.

Methods

A qualitative study was conducted using semi-structured interviews with 15 mMSM (aged ≥16) and 10 professionals from various organisations working with mMSM. mMSM were recruited via sexual health nurses at three STI clinics of a Dutch Public Health Service and flyers; professionals via email, flyers, and the project team’s network. Transcripts were analysed thematically using deductive and inductive coding by two researchers, ensuring intercoder agreement.

Results

Key facilitators for sexual healthcare access included supportive social networks, in-person consultations, and culturally and LGBTQ+-sensitive staff. Main barriers involved fear of stigma rooted in cultural and religious beliefs, limited awareness of available services, and language-related challenges. Suggested outreach strategies included dating app advertisements, short multilingual videos, and translated posters in venues frequented by mMSM (e.g., bars and schools). Notably, most participants accessed services through personal referrals, underlining the importance of including social networks in outreach strategies.

Conclusions

Addressing personal, social and structural barriers while enhancing facilitators contributes to more inclusive and equitable sexual healthcare services. Besides, increasing reach of mMSM through the dissemination of tailored information via social networks, digital platforms, and community settings further supports this objective. These findings inform strategies aimed at reducing health disparities and contribute to broader STI, HIV, and hepatitis prevention goals.

男男性行为的移民男性承受着不成比例的性传播感染负担，但在获得性保健方面遇到独特的障碍。本定性研究探讨了荷兰性保健服务获取和推广策略的mMSM和专业人士对mMSM的个人、社会和结构障碍和促进因素的看法。方法采用半结构化访谈对15名年龄≥16岁的mMSM和10名从事mMSM工作的专业人员进行定性研究。mMSM是通过荷兰公共卫生服务机构的三个性传播感染诊所的性健康护士和传单招募的；专业人士通过电子邮件、传单和项目团队的网络。转录本分析主题使用演绎和归纳编码由两名研究人员，确保编码间的协议。结果支持性社交网络、面对面咨询、对文化和LGBTQ+敏感的工作人员是促进性保健可及性服务的关键因素。主要障碍包括害怕源于文化和宗教信仰的耻辱，对现有服务的认识有限，以及与语言有关的挑战。建议的推广策略包括在mMSM经常光顾的场所（如酒吧和学校）投放约会应用广告、多语言短视频和翻译海报。值得注意的是，大多数参与者通过个人推荐获得服务，强调了将社会网络纳入外展战略的重要性。结论解决个人、社会和结构障碍，同时加强促进人员，有助于提供更包容和公平的性保健服务。此外，通过社交网络、数字平台和社区环境传播量身定制的信息，扩大男同性恋者的覆盖面，进一步支持这一目标。这些发现为旨在减少健康差距的战略提供了信息，并有助于实现更广泛的性传播感染、艾滋病毒和肝炎预防目标。

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引用次数: 0