title: Population movements and the HIV cascade in recently diagnosed patients at the French Guiana -Suriname border.
abstract: Border areas are particular "hot spots" generating high levels of HIV vulnerability and facing great challenges to control epidemics. The objective of this study is to describe the sociodemographic, clinical and biological profiles of newly HIV diagnosed people at the French Guiana - Suriname border, to construct an HIV care cascade and compare it with the Surinamese one. HIV-patients aged over 15 years newly diagnosed in western French Guiana in 2011 and 2012 were included in a retrospective cohort study. Patients were identified using different sources (n = 121). The male-to-female ratio was 0.8, 85% of the patients were of foreign origin, 72% were undocumented migrants, 21% were living in Suriname and 48% had baseline CD4 cell counts <200 cells/mm3. After one year, 34% were lost to follow-up, 54% received treatment, 34% had controlled viremia and 6% died. We observed a disappointing HIV cascade, like that of Suriname, requiring to develop a coordinated healthcare offer on both sides of the border. Targeted efforts through a bi-national collaboration are needed to address the specific issues of cross-border patients to reach the 90*3 UNAIDS's diagnosis, link to care and treatment targets and better control the local epidemic.
authors.affiliation: a Department of Public Health , Centre Hospitalier de l'Ouest Guyanais , Saint-Laurent du Maroni , French Guiana.
authors.forename: Raphael
authors.initials: R
authors.lastname: Jaries
authors.affiliation: a Department of Public Health , Centre Hospitalier de l'Ouest Guyanais , Saint-Laurent du Maroni , French Guiana.
authors.forename: Vincent
authors.initials: V
authors.lastname: Vantilcke
authors.affiliation: c Department of Medicine , Centre Hospitalier de l'Ouest Guyanais , Saint-Laurent du Maroni , French Guiana.
authors.forename: Philippe
authors.initials: P
authors.lastname: Clevenbergh
authors.affiliation: a Department of Public Health , Centre Hospitalier de l'Ouest Guyanais , Saint-Laurent du Maroni , French Guiana.
authors.forename: Jocelyne
authors.initials: J
authors.lastname: Adoissi
authors.affiliation: b Department of Clinical Biology , Centre Hospitalier de l'Ouest Guyanais , Saint-Laurent du Maroni , French Guiana.
authors.forename: Rachida
authors.initials: R
authors.lastname: Boukhari
authors.affiliation: c Department of Medicine , Centre Hospitalier de l'Ouest Guyanais , Saint-Laurent du Maroni , French Guiana.
authors.forename: Caroline
authors.initials: C
authors.lastname: Misslin
authors.affiliation: d Centre d'Investigation Clinique Antilles-Guyane, INSERM 1424, Centre Hospitalier Andrée Rosemon , Cayenne , French Guiana.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Nacher
authors.affiliation: e Department of Medicine , Academic Hospital , Paramaribo , Suriname.
authors.forename: Stephen
authors.initials: S
authors.lastname: Vreden
authors.affiliation: a Department of Public Health , Centre Hospitalier de l'Ouest Guyanais , Saint-Laurent du Maroni , French Guiana.|f Department of Social Epidemiology , Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136) , Paris , France.
authors.forename: Anne
authors.identifier: 0000-0001-6233-1225
authors.initials: A
authors.lastname: Jolivet
mesh_terms: D000293:Adolescent; D000328:Adult; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D005616:French Guiana / Q000453:epidemiology; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology; D006291:Health Policy; D006801:Humans; D059012:Lost to Follow-Up; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013532:Suriname / Q000453:epidemiology; D014171:Transients and Migrants / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: French Guiana; HIV; Suriname; health policy; migrant