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The Government and NHS are failing migrants in the UK living with or at risk of HIV, new National AIDS Trust research finds The Government and NHS are failing to reach and support migrants in the UK living with or at risk of HIV, according to a new report from the UK’s HIV rights charity National AIDS Trust published today. This means the Government will not hit its target to end new cases of HIV by 2030.
HIV and migration: Understanding the barriers faced by people born abroad living with HIV in the UK interviewed migrants living with HIV in the UK. It found migrants are being left behind in the UK’s response to HIV, despite being disproportionately affected by HIV. Respondents said they experienced significant barriers accessing HIV testing, prevention, treatment, and care [1].
In 2019 62% of the new HIV diagnoses in the UK were among people born abroad [2]. The majority of people born abroad diagnosed with HIV between 2009 and 2018 likely acquired HIV while living in the UK [3].
HIV testing and treatment is free to everyone in the UK, regardless of immigration status. However, many migrants are not aware of this and therefore not accessing important HIV testing. Worryingly, 51% who were diagnosed with HIV were diagnosed late, putting them more at risk of becoming seriously ill or passing on the virus [4].
The report identified a number of major barriers for migrants trying to access HIV testing and treatment, including:
lack of access to appropriate information about healthcare entitlements
migrants’ poor understanding of healthcare entitlements and fear and confusion over possible charging for NHS services
‘hostile environment’ policies – such as data sharing between the NHS and Home Office – deterred people born abroad from accessing care and contributed to their late HIV diagnoses
restrictions on being able to work or claim financial support for some migrants forced some migrants into destitution, unable to afford food or travel to appointments.
One respondent – a male in his 30s, born in Latin America – said:
“You have to make a decision – put at risk your health, and not access help, or put at risk your safety and stability and where you are.”
National AIDS Trust recommends:
the Department of Health and Social Care’s upcoming HIV Action Plan outlines actions for HIV prevention and increasing HIV testing for migrants
the Home Office ends its No Recourse to Public Funds policy which provides inadequate protection from destitution
end all circumstances of data sharing between the NHS and Home Office and inform migrants so they regain trust in the health system
end charging migrants for access to some healthcare and no further expansion of charging by the Government
the Home Office and Department of Health and Social Care provide appropriate information for people born abroad on how the healthcare system works, including how to register with a GP.
Deborah Gold, Chief Executive of National AIDS Trust, said:
“Forty years into the HIV epidemic, it is unforgivable the UK’s HIV response is failing migrants to this extent. Given that the public health challenge of HIV so disproportionately affects migrants, most of whom acquire HIV once in the UK, we must act. To reverse the trend in which the majority of migrants are diagnosed late, we must improve the current low levels of HIV testing alongside much greater access to HIV prevention drug PrEP.
“Migrants must be considered a key population in the UK’s response to HIV by the Government, and wider healthcare services. Not doing so seriously jeopardises reaching the Government’s goal of ending new cases of HIV by 2030.
“We urge the Government to specifically include people born abroad in its HIV Action Plan. It must ensure support is in place to improve the quality of life for migrants in the UK living with or at risk of HIV.”
José Carlos, a National AIDS Trust Peer Expert who worked on the report and is living with HIV, said:
“As a migrant living with HIV in the UK, I’ve experienced some barriers trying to get the healthcare I needed. As first I didn’t know or understand the UK’s health system and what my HIV care entitlements were. I was worried my personal details were being shared with the authorities when I went to the clinic initially. It really affected my well-being and emotional health; it was upsetting and difficult.
“Improving the health outcomes of people born abroad living with HIV in the UK and changing the biased narratives about migrants is everyone’s work. It benefits us all.”