Impact of labor migration on HIV trends and clinical outcomes among people living with HIV in Sughd region of Tajikistan

Objective: to assess the impact of labor migration on HIV case detection and clinical outcomes among people living with HIV in the Sughd region of Tajikistan during 2013–2022.

Materials and methods: a retrospective cohort study was conducted among adults aged 18 years and older with HIV, who were newly registered between 2013 and 2022 at AIDS centers in the Sughd region, and received antiretroviral therapy (ART) for at least 6 months (n = 1871). For the purposes of this study, migrants were defined as citizens of Tajikistan who resided outside the country for more than 3 months for work purposes, while non-migrants were defined as individuals who had not traveled abroad for employment. Data were collected from the national electronic surveillance system, and epidemiological and outpatient records. Statistical analyses were performed in RStudio using descriptive statistics, the χ² test, and Poisson regression models to identify independent predictors of mortality (incidence rate ratio [IRR], 95% confidence interval [CI]). Statistical significance was set at p < 0.05.

Results: of 1871 participants, 38% had a history of labor migration. Men predominated among migrants (76%), and mortality was also higher among men (12% vs. 6.8%, p < 0.001). The main route of transmission was a sexual contact (89%). Most patients received the standard ART regimen TDF/3TC/DTG (94%). The proportion of migrants among newly diagnosed HIV cases ranged from 27% to 43% between 2013 and 2022. In a multivariable Poisson model, independent predictors of higher mortality were employment status (unemployed: IRR = 2.60; employed: IRR = 3.37) and rural residence (IRR = 1.18), whereas viral load >1000 copies/mL was not significant (IRR = 0.98).

Conclusion: labor migrants represent a vulnerable group with higher mortality and unfavorable clinical outcomes. These findings highlight the need for targeted programs for early diagnosis, continuity of treatment, and improved access to ART in rural areas to enhance treatment effectiveness among migrants. 

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