Abstract

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.
Detention, 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 country.
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.