Population movements and the HIV cascade in recently diagnosed patients at the French Guiana -Suriname border

ABSTRACT

Border areas are particular “hot spots” generating high levels of HIV vulnerability and facing great challenges to control epidemics. The objective of this study is to describe the sociodemographic, clinical and biological profiles of newly HIV diagnosed people at the French Guiana - Suriname border, to construct an HIV care cascade and compare it with the Surinamese one. HIV-patients aged over 15 years newly diagnosed in western French Guiana in 2011 and 2012 were included in a retrospective cohort study. Patients were identified using different sources (n = 121). The male-to-female ratio was 0.8, 85% of the patients were of foreign origin, 72% were undocumented migrants, 21% were living in Suriname and 48% had baseline CD4 cell counts <200 cells/mm³. After one year, 34% were lost to follow-up, 54% received treatment, 34% had controlled viremia and 6% died. We observed a disappointing HIV cascade, like that of Suriname, requiring to develop a coordinated healthcare offer on both sides of the border. Targeted efforts through a bi-national collaboration are needed to address the specific issues of cross-border patients to reach the 90*3 UNAIDS's diagnosis, link to care and treatment targets and better control the local epidemic.

KEYWORDS:

• HIV
• French Guiana
• Suriname
• migrant
• health policy

Acknowledgements

The authors would like to thank all the persons who helped in collecting the data: Sandrine Dauvilaire and Samuel Beneteau (COREVIH), AIDES Association, Dr Claire Grenier and Dr Alexandrine Vidal (French Red Cross) and Dr Paul Brousse (CHAR).

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Anne Jolivet http://orcid.org/0000-0001-6233-1225