, Volume 46, Issue 5, pp 659–667 | Cite as

Refugees and family-reunified immigrants have a high incidence of HIV diagnosis and late presentation compared with Danish born: a nationwide register-based cohort study

  • Laura Deen
  • Susan Cowan
  • Christian WejseEmail author
  • Jørgen Holm Petersen
  • Marie Norredam
  • ESCMID Study Group for Infections in Travellers and Migrants
Original Paper



Migrants represent a considerable proportion of HIV diagnoses in Europe and are considered a group at risk of late presentation. This study examined the incidence of HIV diagnoses and the risk of late presentation according to migrant status, ethnic origin and duration of residence.


We conducted a historically prospective cohort study comprising all adult migrants to Denmark between 1.1.1993 and 31.12.2010 (n = 114.282), matched 1:6 to Danish born by age and sex. HIV diagnoses were retrieved from the National Surveillance Register and differences in incidence were assessed by Cox regression model. Differences in late presentation were assessed by logistic regression.


Both refugees (HR = 5.61; 95% CI 4.45–7.07) and family-reunified immigrants (HR = 10.48; 95% CI 8.88–12.36) had higher incidence of HIV diagnoses compared with Danish born and the incidence remained high over time of residence for both groups. Migrants from all regions, except Western Asia and North Africa, had higher incidence than Danish born. Late presentation was more common among refugees (OR = 1.87; 95% CI 1.07–3.26) and family-reunified immigrants (OR = 2.30; 95% CI 1.49–3.55) compared with Danish born. Southeast Asia and Sub-Saharan Africa were the only regions with a higher risk of late presentation. Late presentation was only higher for refugees within 1 year of residence, whereas it remained higher within 10 years of residence for family-reunified immigrants.


This register-based study revealed a higher incidence of HIV diagnoses and late presentation among migrants compared with Danish born and the incidence remained surprisingly high over time.


Migrants Ethnic minority Refugee HIV infection Late presentation 




Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Standards

The project was approved by the Danish Protection Agency (No 2012-41-0065). Further ethical approval regarding registry-based research is not required in Denmark. The data set was made available and analysed in an anonymous form by remote online access to the data set stored at Statistics Denmark.

Supplementary material

15010_2018_1167_MOESM1_ESM.docx (27 kb)
Supplementary material 1 (DOCX 28 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Section of Immigrant Medicine, Department of Infectious DiseaseCopenhagen University HospitalHvidovreDenmark
  2. 2.Department of Infectious Disease EpidemiologyStatens Serum InstitutCopenhagen SDenmark
  3. 3.Department of Public Health, Centre for Global HealthAarhus UniversityAarhus CDenmark
  4. 4.Department of Infectious DiseasesAarhus University HospitalAarhus NDenmark
  5. 5.Section of Biostatistics, Department of Public HealthUniversity of CopenhagenCopenhagen KDenmark
  6. 6.Danish Research Centre for Migration, Ethnicity and Health (MESU), Department of Public Health, Section for Health Services ResearchUniversity of CopenhagenCopenhagen KDenmark

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