Barriers to HIV protection for immigrant and stateless populations near the Thailand-burma border

The ethno-linguistically diverse minorities occupying the highlands of the Thai-Burma border comprise a large proportion of internal migrants. We assess whether internal migration influences HIV knowledge and access to HIV testing. We use the United Nations Educational, Cultural, and Scientific Organization Highland Peoples Survey from 2010 of 70,377 individuals, representing 292 villages, to stage random intercept logistic models to calculate crude and adjusted relative odds of migrant workers having heard of HIV, recognizing HIV modes of transmission, and knowing where to get tested. Individuals that have been migrant workers are at a 56% lower odds of having heard of HIV than non-migrants (OR: 0.44; 95% CI: 0.35-0.61). Controlling for age, marital status, Thai language ability, citizenship, sex, ethnicity, and education, these individuals remain at a 28% lower odds of having heard of HIV (OR: 0.77; 95% CI: 0.55-1.07). The odds of former migrant workers reporting accurate HIV transmission information are 17% lower than of non-migrants (OR: 0.83; 95% CI: 0.66-1.05) and their odds of knowing where to get tested for HIV are 30% less than of non-migrants (OR: 1.11; 95% CI: 0.91-1.35). Individuals from Thai border villages that have migrated for work in the past are much less likely to have heard of HIV/AIDS, to have correct HIV transmission information, and to know where to get tested for HIV than non-migrant workers. This association is largely explained by differences in citizenship status, education and Thai language skills. Culturally and linguistically appropriate health education must be directed toward vulnerable migrant populations.