Detention, removal and pople living with HIV
Presented by Sarah Radcliffe (United Kingdom).
S. Radcliffe, J. Murray, Y. Azad
NAT - the National AIDS Trust, London, United Kingdom
Issues: The global movement of people is significant to all national HIV
epidemics, and not only in defining how HIV is spread. The immigration processes and
controls associated with migration present challenges for provision
of effective HIV healthcare.
These issues are particularly
pertinent in considering the HIV treatment and care needs of refused asylum
seekers or undocumented migrants who are detained and forcibly removed.
Description: In 2006, NAT (The National AIDS Trust) surveyed healthcare
managers in UK Immigration Removal Centres (IRCs) about the management of HIV
among detainees. The findings, reported
in 2007, included examples of good practice, but also evidence of inconsistency
in relation to testing, access to medication and preparation for removal.
Based on these findings, NAT and BHIVA
(British HIV Association) developed Advice on HIV care in the IRC setting. The Advice gives examples of best practice
around continuity of care: ensuring unbroken access to medication; maintaining contact
with treating clinicians in the UK
and creating links with clinicians and support organisations in destination
countries; and providing at least 3 month´s medication upon removal.
Removal and People Living with HIV: Advice for healthcare and voluntary sector
professionals was published in June 2009
and distributed across the detention estate, to clinics who treat detainees
with HIV, and to authorities who commission services for IRCs.
Lessons learned: The Advice has been used by HIV and
refugee support organisations to ensure that HIV positive detainees receive the
care they are entitled to, and to reverse removal decisions, where there had
been inadequate preparation for removal and treatment in the destination
In November 2009, NAT and BHIVA hosted a
seminar to review the first 6 months of implementation of the Advice.
Next steps: In 2010/11, NAT will repeat the survey of
healthcare managers, to assess what impact the Advice has had.
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