Background
In
the European Union/European Economic Area (EU/EEA), migrants from high-endemic
countries are disproportionately affected by HIV. Between 2007 and 2012,
migrants represented 39 % of reported HIV cases. There is growing evidence
that a significant proportion of HIV acquisition among migrant populations
occurs after their arrival in Europe.
Discussion
Migrants
are confronted with multiple risk factors that shape patterns of population HIV
susceptibility and vulnerability, which simultaneously affect HIV transmission.
Undocumented migrants incur additional risks for contracting HIV due to limited
access to adequate health care services, protection and justice, alongside
insecure housing and employment conditions.
All
EU/EEA countries have ratified a number of international and regional human
rights instruments that enshrine access to health care as a human right that
should be available to everyone without discrimination.
From
a clinical and public health perspective, early HIV care and treatment is
associated with viral suppression, improved health outcomes and reductions in
transmission risks. A current challenge of the HIV epidemic is to reach the
highest proportion of overall viral suppression among people living with HIV in
order to impact on HIV transmission.
Although
the majority of EU/EEA countries regard migrants as an important sub-population
for their national responses to HIV, and despite the overwhelming evidence of
the individual and public health benefits associated with HIV care and
treatment, a significant number of EU/EEA countries do not provide
antiretroviral treatment to undocumented migrants.
Summary
HIV
transmission dynamics in migrant populations depend on the respective weight of
all risk and vulnerability factors to which they are exposed, which act
together in a synergistic way. People who are not linked to HIV care will
continue to unwillingly contribute to the on-going transmission of HIV.
Following the recommendations of the European Union Agency for Fundamental
Rights, ensuring access to HIV-care for all sub-populations, including
undocumented migrants, would fulfil the human rights of those populations and
also strengthen the control of HIV incidence among those not currently able to
access HIV care.
Below: Availability of ART for
undocumented migrants in the EU/EEA as reported in March 2014 at the occasion
of the monitoring of the Dublin Declaration implementation. Source: European
Centre for Disease Prevention and Control. Thematic report: Migrants.
Monitoring implementation of the Dublin Declaration on Partnership to Fight
HIV/AIDS in Europe and Central Asia: 2014 progress report. Stockholm: ECDC; 2015
Full article at:
By:
1Scientific Institute of Public Health, Epidemiology of Infectious
Diseases, Juliette Wytsmanstraat 14, Brussels, 1050, Belgium
2Institute of Health Carlos III, National Center for Epidemiology,
C/Sinesio Delgado 6, Madrid, 28029, Spain
3University College London, Research Department of Infection &
Population Health, London WC1E 6JB, UK
4Royal Free London NHS Foundation Trust, Pond Street, London NW3
2QG, UK
5Public Health England, PHIV & STI Department, 61 Colindale
Avenue, London NW9 5EQ, UK
6Statens Serum Institut, Department of Infectious Medicine
Epidemiology, Artillerivej 5, Copenhagen S, 2300, Denmark
7PICUM- Platform for International Cooperation on Undocumented
Migrants, Rue du Congrès 37-41 / 5, Brussels 1000, Belgium
8European Centre for Disease Prevention and Control, Surveillance
and Response Support Unit, Tomtebodavagen 11A, Stockholm, 171 83, Sweden
9European Centre for Disease Prevention and Control, Office of the
Chief Scientist, Tomtebodavagen 11A, Stockholm, 171 83, Sweden
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