title: Migrants travelling to their country of origin: a bridge population for HIV transmission?
abstract: BACKGROUND
  By having unprotected heterosexual contact in both The Netherlands and their homeland, migrants who travel to their homeland might form a bridge population for HIV and sexually transmitted infection (STI) transmission. We studied the determinants for such a population in two large migrant communities in The Netherlands.
  
  
  METHODS
  From 2003 to 2005, 1938 people of Surinamese and Antillean origin were recruited at social venues in two large cities, interviewed and their saliva samples tested for HIV antibodies. We used multivariate multinomial logistic regression to explore characteristics of groups with four risk levels (no, low, moderate and high) for cross-border transmission.
  
  
  RESULTS
  1159/1938 (60%) participants had travelled from The Netherlands to their homeland in the previous 5 years and 1092 (94%) of them reported partnerships and condom use in both countries. Of these 9.2% reported having unprotected sex with partners in both countries. People in this high-risk or bridge population group were more likely to be male, frequent travellers and older compared with people who had no sex or had sexual contact solely in one country in the past 5 years.
  
  
  CONCLUSIONS
  Older male travellers of Surinamese and Antillean origin are at high risk for cross-border heterosexual transmission of HIV/STIs. They should be targeted by prevention programmes, which are focused on sexual health education and HIV/STI testing, to raise their risk awareness and prevent transmission.
authors.affiliation: Department of Research, Cluster Infectious Diseases, Health Service of Amsterdam, PO Box 2200, 1000 CE Amsterdam, The Netherlands. mkramer@ggd.amsterdam.nl
authors.forename: M A
authors.initials: MA
authors.lastname: Kramer
authors.forename: M G
authors.initials: MG
authors.lastname: van Veen
authors.forename: E L M Op
authors.initials: EL
authors.lastname: de Coul
authors.forename: R B
authors.initials: RB
authors.lastname: Geskus
authors.forename: R A
authors.initials: RA
authors.lastname: Coutinho
authors.forename: M J W
authors.initials: MJ
authors.lastname: van de Laar
authors.forename: M
authors.initials: M
authors.lastname: Prins
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009427:Netherlands Antilles / Q000208:ethnology; D012747:Sexual Partners; D013532:Suriname / Q000208:ethnology; D014171:Transients and Migrants / Q000706:statistics & numerical data*; D014195:Travel; D047568:Unsafe Sex / Q000706:statistics & numerical data; D055815:Young Adult