UNAIDS 90-90-90 Target and Retention in Care of a Cohort of Migrants Living with HIV in a Tertiary Referral Hospital in Florence, Italy.

Abstract

Migrant Living with HIV (MLWH) are facing many barriers. Proposing targeted interventions requires a better understanding of the local epidemiology, but data are scarce. This population often comprises vulnerable groups such as men who have Sex with men and transgender individuals. This single-center cohort study aims to estimate the achievement of the Joint United Nations Programme on HIV/AIDS 90-90-90 goals and the 8-year loss-to-follow-up (LTFU) incidence rate in a cohort of MLWH under treatment at the Infectious and Tropical Diseases Unit of the "Careggi University Hospital", Florence, Italy. We enrolled MLWH taken in care from 01/01/2014 to 31/12/2022. The end of the study was the end of follow-up (30/04/2023) or the date of LTFU (unreachable, relocated to another center, or dead). We enrolled 201 migrants with a median age of 33 [IQR 27-43]. One-hundred-and-six (52.7%) came from Latin America, mainly from Peru (40.2%; n = 81). About a third were transgender women (TW) (32.8%; n = 66). Seventy-six (37.8%) were migrants out-of-status (MOS). HIV was diagnosed in Italy in 58.7% (n = 118). Ninety (44.8%) were treatment-naïve, sex-working was reported in 39 patients (19.4%) before and 55 (27.4%) after migration. One-hundred-thirty-eight (68.7%) were retained in care. The 8-year-LTFU incidence rate was 8.96 per 100 p/y (95% CI 7.0-11.4). MOS had a higher risk of LTFU (aHR 2.68; p = 0.005). Conversely, being a TW (aHR 0.33; p = 0.024) and taking a single-tablet-regimen (aHR 0.44; p = 0.008) were protective factors.In our setting the 90-90-90 targets have not yet been fully achieved, and high rates of LTFU have been observed.