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International migrants left behind in HIV response – study

International migrants are at increased risk of HIV infection due to reduced access to pre-exposure prophylaxis (PrEP), which is up to 99% effective in preventing HIV. 

Photo by Keagan Henman from Unsplash.com

International migrants are at increased risk of HIV infection due to reduced access to pre-exposure prophylaxis (PrEP), which is up to 99% effective in preventing HIV. 

This is according to a study – “Improving access to oral pre-exposure prophylaxis for HIV among international migrant populations” by Warittha Tieosapjaroen, Ying Zhang, Christopher K. Fairley, et al – that was published in The Lancet Public Health.

For this study, the researchers reviewed existing literature, and from 593 articles identified in the initial search, 17 articles met the eligibility criteria. After combing these researches, the researchers found that:

  • International migrants encountered multiple barriers in accessing PrEP, including lack of awareness, low risk perception for HIV, and service issues such as cost and provider discrimination.
  • They also faced uncertainty in navigating the health system and stigma around HIV, gay and bisexual identities, and using PrEP. 

For senior author Ong, there is a need for culturally tailored approaches for PrEP access, and to address migration and HIV-related discriminatory policies, including making it much harder for people with HIV to obtain permanent residency.

“Navigating the landscape of HIV prevention is like traversing a maze, with barriers blocking the way at every turn,” Ong said. “Culturally tailored approaches act as guiding lights, illuminating the path forward.

On added: “To improve health inequities, we suggest strategies at societal, service and individual levels that address the barriers of using PrEP among those who would benefit from it the most.”

Ong similarly stressed that while PrEP was “game-changing” in preventing HIV, actually getting this into the hands of the right people remains a significant barrier in the fight against HIV. “Our study shows that it is possible to improve health inequity in our society if we can direct resources to the right people.” 

The study involved Alfred Health, Monash University, Australia, UNAIDS, WHO, UNSW Sydney, and the London School of Hygiene & Tropical Medicine.

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