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Canadian Journal of Public Health

, Volume 101, Issue 1, pp 44–49 | Cite as

Regional and Temporal Trends in Migration among People Living with HIV/AIDS in British Columbia, 1993-2005

  • Viviane D. Lima
  • Eric Druyts
  • Julio S. G. Montaner
  • Robert S. Hogg
Quantitative Research

Abstract

Objectives

To examine regional and temporal trends in migration among patients receiving HIV treatment in British Columbia (BC).

Methods

Patients initiating antiretroviral therapy in BC between January 1993 and November 2004 were followed until November 2005. Migration was calculated as the cumulative number of times a patient’s residential address changed during their course of treatment. Analyses were performed at the provincial and at the regional health authority (HA) and local health area levels. Demographic methods were used to estimate the in- and out-migration rates, indices of dissimilarity and concentration across regions over time.

Results

A total of 3,588 participants were followed during the study period. Individuals who migrated most often migrated to the Vancouver Coastal HA (from the Interior: 30%, Fraser: 41%, Vancouver Island: 28%, and Northern: 19%), specifically the city of Vancouver, which has been treating the most patients with HIV since the early stages of the epidemic. We also showed that this movement intensified as more contemporary HAART regimens became available (p-value for trend <0.01).

Discussion

Our results demonstrate that migration among people with HIV in BC is not homogeneous, with areas around large urban centres having the highest influx of patients. It is thus important that health authorities in BC work in partnership to monitor and evaluate accessibility of HIV-related health care services to ensure universal access for all patients. Furthermore, enhanced HIV care and support services need to be developed, on a province-wide basis, and funding allocation needs to be adjusted to reflect patient migration in BC.

Keywords

HIV/AIDS migration regional analysis trend British Columbia Canada 

Résumé

Objectifs

Examiner les tendances migratoires régionales et temporelles chez les patients traités contre le VIH en Colombie-Britannique (C.-B.).

Méthode

Nous avons suivi jusqu’en novembre 2005 les patients ayant commencé un traitement antirétroviral en C.-B. entre janvier 1993 et novembre 2004. Leurs migrations ont été calculées selon le nombre total de changements d’adresse domiciliaire des patients durant leur traitement. Nous avons analysé les données à l’échelle provinciale et à l’échelle des régies régionales de la santé (RRS) et des services de santé municipaux. Des méthodes démographiques ont servi à estimer les taux d’immigration et d’émigration, les indices de dissimilarité et la concentration par région au fil du temps.

Résultats

Nous avons suivi 3 588 participants durant la période de l’étude. Les sujets ayant migré se déplaçaient le plus souvent vers la RRS de la région côtière de Vancouver (en provenance de l’intérieur de la province: 30%, de la vallée du Fraser: 41%, de l’île de Vancouver: 28%, et du Nord de la province: 19%), plus précisément vers la ville de Vancouver, qui traite le plus grand nombre de patients atteints de VIH depuis les premières manifestations de l’épidémie. Nous avons également montré que ce mouvement s’est intensifié lorsque la multithérapie antirétrovirale est devenue disponible (valeur prédictive de la tendance <0,01).

Discussion

Nos résultats montrent que les flux migratoires des personnes atteintes du VIH en C.-B. ne sont pas homogènes, car ce sont les zones périphériques des grands centres urbains qui reçoivent le plus de patients. Il est donc important que les autorités sanitaires de la province travaillent en partenariat pour surveiller et évaluer l’accessibilité des services de santé liés au VIH pour que tous les patients y aient droit. Il faudrait aussi mettre au point des services de soins et de soutien améliorés, dans toute la province, et réviser l’affectation des fonds en fonction des flux migratoires des patients atteints du VIH.

Motsclés

VIH migration analyse régionale tendance Colombie-Britannique Canada 

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Copyright information

© The Canadian Public Health Association 2010

Authors and Affiliations

  • Viviane D. Lima
    • 1
    • 2
  • Eric Druyts
    • 1
  • Julio S. G. Montaner
    • 1
    • 2
  • Robert S. Hogg
    • 1
    • 3
  1. 1.British Columbia Centre for Excellence in HIV/AIDS Drug Treatment ProgramBC Centre for Excellence in HIV/AIDSVancouverCanada
  2. 2.Department of Medicine, Faculty of MedicineUniversity of British ColumbiaVancouverCanada
  3. 3.Faculty of Health SciencesSimon Fraser UniversityBurnabyCanada

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