title: Active recruitment strategy in disadvantaged immigrant populations improves the identification of human immunodeficiency but not of hepatitis B or C virus infections.
abstract: BACKGROUND
  Barriers to access medical screening and care may underestimate the number of diseased subjects among immigrant populations.
  
  
  OBJECTIVE
  To evaluate the prevalence of human immunodeficiency virus, hepatitis B virus and hepatitis C virus infections among immigrants recruited in a disadvantaged area.
  
  
  METHODS
  The study enrolled all subjects seen between 1999 and 2009 at an on-site health and family counselling centre for immigrants. During the first 6 years of the study a pro-active recruitment was performed using a mobile unit.
  
  
  RESULTS
  Overall 2681 subjects were enrolled (median age: 31 years; 52.8% males; 82.3% from Sub-Saharan Africa; 13.9% of the women were sex workers). A total of 206 subjects (7.6%) were hepatitis B surface antigen-positive, 84 (3.6%) were anti-hepatitis C virus-positive, 129 (5%) were anti-human immunodeficiency virus-positive, 84 (3.1%) were drug users, and 436 (16.3%) were alcohol abusers. The prevalence of hepatitis B surface antigen and anti-hepatitis C virus remained consistent throughout the study period, while the prevalence of human immunodeficiency virus significantly decreased. At multivariate analysis, hepatitis B virus infection was associated with male gender, hepatitis C virus infection with drug addiction, and human immunodeficiency virus infection was associated with female gender, drug addiction, and active recruitment.
  
  
  CONCLUSIONS
  An active recruitment strategy should be considered to reach disadvantaged populations at high risk of human immunodeficiency virus infection.
authors.affiliation: Viral Hepatitis Unit, Department of Internal Medicine, Second University, Naples, Italy.
authors.forename: Gianfranca
authors.initials: G
authors.lastname: Stornaiuolo
authors.affiliation: Social Medical Voluntary Association "Jerry Essan Masslo", Castelvolturno, Caserta, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Cuniato
authors.affiliation: Viral Hepatitis Unit, Department of Internal Medicine, Second University, Naples, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Cuomo
authors.affiliation: Social Medical Voluntary Association "Jerry Essan Masslo", Castelvolturno, Caserta, Italy.
authors.forename: Espedito
authors.initials: E
authors.lastname: Nocera
authors.affiliation: Viral Hepatitis Unit, Department of Internal Medicine, Second University, Naples, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Brancaccio
authors.affiliation: Social Medical Voluntary Association "Jerry Essan Masslo", Castelvolturno, Caserta, Italy.
authors.forename: Maddalena
authors.initials: M
authors.lastname: De Rosa
authors.affiliation: Viral Hepatitis Unit, Department of Internal Medicine, Second University, Naples, Italy.
authors.forename: Agostina
authors.initials: A
authors.lastname: Pontarelli
authors.affiliation: Social Medical Voluntary Association "Jerry Essan Masslo", Castelvolturno, Caserta, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Grasso
authors.affiliation: Unit of Pathology, G. Moscati Hospital, Aversa, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Danzi
authors.affiliation: Faculty of Communication Sciences, Institute for Public Communication-ICP, Swiss Italian University, Lugano, Switzerland.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Grossi
authors.affiliation: Social Medical Voluntary Association "Jerry Essan Masslo", Castelvolturno, Caserta, Italy.
authors.forename: Renato F
authors.initials: RF
authors.lastname: Natale
authors.affiliation: Viral Hepatitis Unit, Department of Internal Medicine, Second University, Naples, Italy. Electronic address: giovannib.gaeta@unina2.it.
authors.forename: Giovanni B
authors.initials: GB
authors.lastname: Gaeta
mesh_terms: D000328:Adult; D017954:Africa South of the Sahara / Q000208:ethnology; D000352:Africa, Northern / Q000208:ethnology; D000367:Age Factors; D000437:Alcoholism / Q000453:epidemiology*; D001208:Asia / Q000208:ethnology; D060085:Coinfection / Q000453:epidemiology; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005061:Europe, Eastern / Q000208:ethnology; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology*; D006509:Hepatitis B / Q000175:diagnosis / Q000453:epidemiology*; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D018579:Patient Selection; D015995:Prevalence; D016016:Proportional Hazards Models; D019966:Substance-Related Disorders / Q000453:epidemiology*; D055815:Young Adult
keywords: HIV infection; Hepatitis B; Hepatitis C; Immigrants