2023-09-28 14:46:10 +00:00
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abstract: 'Purpose of review
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Health policy makers aspire to achieve an HIV treatment `cascade'' in
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which diagnostic and treatment services are accessed early and routinely
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by HIV-infected individuals. However, migrants and highly mobile
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individuals are likely to interact with HIV treatment programs and the
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healthcare system in ways that reflect their movement through time and
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place, affecting their successful progression through the HIV treatment
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cascade. We review recent research that has examined the challenges in
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effective and sustained HIV treatment for migrants and mobile
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populations.
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Recent findings
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Mobility is associated with increased risk of antiretroviral therapy
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(ART) nonadherence, lost to follow-up, deterioration in CD4 count,
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HIV-related death, development of drug resistance and general
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noncontinuity of HIV care. Migrants'' slow progression through the HIV
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treatment cascade can be attributed to feelings of confusion,
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helplessness; an inability to effectively communicate in the native
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language; poor knowledge about administrative or logistical requirements
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of the healthcare system; the possibility of deportation or expulsion
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based on the legal status of the undocumented migrant; fear of
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disclosure and social isolation from the exile or compatriot group.
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Travel or transition to the host country commonly makes it difficult for
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migrants to remain enrolled in ART programs and to maintain adherence to
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treatment.
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Summary
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Existing public health systems fail to properly account for migration,
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and actionable knowledge of the health requirements of migrants is still
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lacking. A large body of research has shown that migrants are more
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likely to enter into the healthcare system late and are less likely to
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be retained at successive stages of the HIV treatment cascade.
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HIV-infected migrants are especially vulnerable to a wide range of
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social, economic and political factors that include a lack of direct
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access to healthcare services; exposure to difficult or oppressive work
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environments; the separation from family, friends and a familiar
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sociocultural environment. Realizing the full treatment and preventive
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benefits of the UNAIDS 90-90-90 strategy will require reaching all
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marginalized subpopulations of which migrants are a particularly large
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and important group.'
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affiliation: 'Tanser, F (Corresponding Author), Univ KwaZulu Natal, Africa Ctr Hlth
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\& Populat Studies, POB 198, ZA-3935 Mtubatuba, South Africa.
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Tanser, Frank; Baernighausen, Till; Vandormael, Alain, Univ KwaZulu Natal, Wellcome
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Trust Africa Ctr Hlth \& Populat Studies, Mtubatuba, South Africa.
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Tanser, Frank, Univ KwaZulu Natal, Sch Nursing \& Publ Hlth, Durban, South Africa.
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Baernighausen, Till, Harvard TH Chan Sch Publ Hlth, Dept Global Hlth \& Populat,
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Boston, MA USA.
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Dobra, Adrian, Univ Washington, Dept Stat, Seattle, WA 98195 USA.
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Dobra, Adrian, Univ Washington, Ctr Studies Demog \& Ecol, Ctr Stat \& Social Sci,
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Dept Biobehav Nursing \& Hlth Syst, Seattle, WA 98195 USA.'
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author: Tanser, Frank and Baernighausen, Till and Vandormael, Alain and Dobra, Adrian
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author-email: ftanser@gmail.com
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author_list:
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- family: Tanser
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given: Frank
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- family: Baernighausen
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given: Till
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- family: Vandormael
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given: Alain
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- family: Dobra
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given: Adrian
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da: '2023-09-28'
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doi: 10.1097/COH.0000000000000192
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eissn: 1746-6318
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files: []
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issn: 1746-630X
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journal: CURRENT OPINION IN HIV AND AIDS
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keywords: antiretroviral therapy; HIV epidemiology; key populations; migration
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keywords-plus: 'MIDDLE-INCOME COUNTRIES; ANTIRETROVIRAL THERAPY; STRUCTURAL BARRIERS;
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UNITED-STATES; PUBLIC-HEALTH; CARE SERVICES; BLACK-PEOPLE; SOUTH-AFRICA;
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FOLLOW-UP; SCALE-UP'
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language: English
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month: NOV
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number: '6'
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number-of-cited-references: '89'
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orcid-numbers: 'Tanser, Frank/0000-0001-9797-0000
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Vandormael, Alain/0000-0002-5742-0511'
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pages: 430-438
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papis_id: 82fd0ad5334c393bef7ada2502e66858
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ref: Tanser2015hivtreatment
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researcherid-numbers: 'Bärnighausen, Till/Y-2388-2019
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Tanser, Frank/ABE-8326-2021
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'
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tags:
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- review
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times-cited: '75'
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title: HIV treatment cascade in migrants and mobile populations
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000369718800006
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usage-count-last-180-days: '0'
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usage-count-since-2013: '22'
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volume: '10'
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web-of-science-categories: Immunology; Infectious Diseases
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year: '2015'
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