HIV in Latin American migrants in the UK: A neglected population in the 95-95-95 targets.

Background: The UK has reached the UNAIDS 2025 targets (of 95% of those living with HIV to be diagnosed, 95% to be on treatment and 95% of those on treatment to be virally suppressed). However, it is not known whether this target is met in subgroups such as migrant populations. Latin Americans are a fast-growing migrant group in the UK and have low engagement with healthcare services, yet little is known about the HIV profile in this population. This study aimed to explore the profile of Latin American migrants under HIV care in the UK, and to identify any gaps in the 95-95-95 target in this population.

Methods: Country of birth- and gender- stratified prevalence of HIV in Latin American migrants in the UK (as of December 2022) was estimated using data from the HIV and AIDS Reporting System and the Office for National Statistics. UNAIDS (2024) estimates from Latin American countries were used as proxies for expected prevalences and applied to Latin American demography in England to calculate expected cases. The ratio of the observed (or diagnosed) cases to the expected cases was calculated to estimate potential underdiagnosis.

Results: A total of 2482 migrants born in Latin American countries were diagnosed with (and under care for) HIV in the UK (observed prevalence 841 per 100 000 population) by the end of 2022. The highest observed prevalence was in men born in Country 3 (2431 per 100 000 population) and the lowest in women born in Country 13 (30 per 100 000 population). Some 89% (n = 2219) of Latin American migrants under care for HIV were men, with 263 women under care with HIV in the whole of the UK. For women born in five of the countries of the region, it was estimated that only 14%, 17%, 25%, 26% and 33% of women living with HIV were under care.

Conclusions: There may be a significant burden of underdiagnosis of HIV among Latin American women in the UK. Although based on some assumptions (notably the application of national HIV estimates to migrant populations which have a different risk profile), the gender disparity is striking. Community engagement and culturally appropriate targeted awareness raising and testing campaigns are recommended.