262837 Ensuring Access to HIV Treatment for Cross-Border Migrants in India from Bangladesh and Nepal

Monday, October 29, 2012 : 1:00 PM - 1:15 PM

Fiona Samuels , Overseas Development Institute, London, United Kingdom
Sanju Wagle , CARE Nepal, Kathmandu, Nepal
Tahmina Sultana , Pragati Insurance Bhaban (9th - 13th floor), CARE Bangladesh, Dhaka, Bangladesh
Mirza Manbira Sultana , CARE Bangladesh, Dhaka, Bangladesh
Shantamay Chatterjee , CARE India, Delhi, India
Navneet Kaur , CARE India, Delhi, India
Lenette Golding, PhD, MPH , Child Health and Nutrition, CARE USA, Atlanta, GA
Orianne Boyer , CARE Nepal, Kathmandu, Nepal
South Asia is home to over two million of the estimated 33.3 million people living with HIV (PLHIV) worldwide. Countries in the region are characterized as having epidemics that are concentrated amongst specific most-at-risk-groups (MARPS) including sex workers, injecting drug users, men who have sex with men and, increasingly, migrants. Many people from Nepal and Bangladesh migrate to India in search of work. Some migrants are HIV+ or become infected while working in India. A study was conducted to assess migrants' access to antiretroviral treatment (ART). Baseline research, using both quantitative and qualitative methods, was conducted between November 2010 and March 2011. Nepali and Bangladeshi migrant workers (N = 2,452) provided information pertaining to access to health services for migrants at source and destination points. The data indicate that migrants are unable to access ART unless they have a valid proof of residence – which most migrants lack. Moreover, migrants are reluctant to access government health and social services because of discriminatory attitudes and behaviors of staff. Many turn to private doctors or hospitals, despite their high costs, where staff offer impartial treatment. Because of the cost of care, many migrants self-medicate and delay treatment until they go home. Nevertheless, access to ART for cross-border migrants is not impossible in India even though channels to access services are complex or unknown to the migrants. Through facilitation of NGOs or PLHIV networks, CARE's EMPHASIS program is setting up a referral mechanism aiming at ensuring access to ART services for cross-border migrants.

Learning Areas:
Advocacy for health and health education
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Provision of health care to the public
Public health or related laws, regulations, standards, or guidelines

Learning Objectives:
(1) Describe the results of operational research pertaining to migrants’ access to antiretroviral treatment (ART) in India; (2) Explain the approach the Enhancing Mobile Populations’ Access to HIV & AIDS Services Information and Support (EMPHASIS), a five-year project working with local partners and CARE country offices in India, Nepal and Bangladesh, is taking to ensure access to health and HIV services for Nepali and Bangladeshi migrant workers in India.

Keywords: Migrant Health, Access to Health Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a senior technical advisor working on the project listed in this abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3240.0: HIV/AIDS