abstract: 'Purpose of review

  Health policy makers aspire to achieve an HIV treatment `cascade'' in

  which diagnostic and treatment services are accessed early and routinely

  by HIV-infected individuals. However, migrants and highly mobile

  individuals are likely to interact with HIV treatment programs and the

  healthcare system in ways that reflect their movement through time and

  place, affecting their successful progression through the HIV treatment

  cascade. We review recent research that has examined the challenges in

  effective and sustained HIV treatment for migrants and mobile

  populations.

  Recent findings

  Mobility is associated with increased risk of antiretroviral therapy

  (ART) nonadherence, lost to follow-up, deterioration in CD4 count,

  HIV-related death, development of drug resistance and general

  noncontinuity of HIV care. Migrants'' slow progression through the HIV

  treatment cascade can be attributed to feelings of confusion,

  helplessness; an inability to effectively communicate in the native

  language; poor knowledge about administrative or logistical requirements

  of the healthcare system; the possibility of deportation or expulsion

  based on the legal status of the undocumented migrant; fear of

  disclosure and social isolation from the exile or compatriot group.

  Travel or transition to the host country commonly makes it difficult for

  migrants to remain enrolled in ART programs and to maintain adherence to

  treatment.

  Summary

  Existing public health systems fail to properly account for migration,

  and actionable knowledge of the health requirements of migrants is still

  lacking. A large body of research has shown that migrants are more

  likely to enter into the healthcare system late and are less likely to

  be retained at successive stages of the HIV treatment cascade.

  HIV-infected migrants are especially vulnerable to a wide range of

  social, economic and political factors that include a lack of direct

  access to healthcare services; exposure to difficult or oppressive work

  environments; the separation from family, friends and a familiar

  sociocultural environment. Realizing the full treatment and preventive

  benefits of the UNAIDS 90-90-90 strategy will require reaching all

  marginalized subpopulations of which migrants are a particularly large

  and important group.'
affiliation: 'Tanser, F (Corresponding Author), Univ KwaZulu Natal, Africa Ctr Hlth
  \& Populat Studies, POB 198, ZA-3935 Mtubatuba, South Africa.

  Tanser, Frank; Baernighausen, Till; Vandormael, Alain, Univ KwaZulu Natal, Wellcome
  Trust Africa Ctr Hlth \& Populat Studies, Mtubatuba, South Africa.

  Tanser, Frank, Univ KwaZulu Natal, Sch Nursing \& Publ Hlth, Durban, South Africa.

  Baernighausen, Till, Harvard TH Chan Sch Publ Hlth, Dept Global Hlth \& Populat,
  Boston, MA USA.

  Dobra, Adrian, Univ Washington, Dept Stat, Seattle, WA 98195 USA.

  Dobra, Adrian, Univ Washington, Ctr Studies Demog \& Ecol, Ctr Stat \& Social Sci,
  Dept Biobehav Nursing \& Hlth Syst, Seattle, WA 98195 USA.'
author: Tanser, Frank and Baernighausen, Till and Vandormael, Alain and Dobra, Adrian
author-email: ftanser@gmail.com
author_list:
- family: Tanser
  given: Frank
- family: Baernighausen
  given: Till
- family: Vandormael
  given: Alain
- family: Dobra
  given: Adrian
da: '2023-09-28'
doi: 10.1097/COH.0000000000000192
eissn: 1746-6318
files: []
issn: 1746-630X
journal: CURRENT OPINION IN HIV AND AIDS
keywords: antiretroviral therapy; HIV epidemiology; key populations; migration
keywords-plus: 'MIDDLE-INCOME COUNTRIES; ANTIRETROVIRAL THERAPY; STRUCTURAL BARRIERS;

  UNITED-STATES; PUBLIC-HEALTH; CARE SERVICES; BLACK-PEOPLE; SOUTH-AFRICA;

  FOLLOW-UP; SCALE-UP'
language: English
month: NOV
number: '6'
number-of-cited-references: '89'
orcid-numbers: 'Tanser, Frank/0000-0001-9797-0000

  Vandormael, Alain/0000-0002-5742-0511'
pages: 430-438
papis_id: 82fd0ad5334c393bef7ada2502e66858
ref: Tanser2015hivtreatment
researcherid-numbers: 'Bärnighausen, Till/Y-2388-2019

  Tanser, Frank/ABE-8326-2021

  '
tags:
- review
times-cited: '75'
title: HIV treatment cascade in migrants and mobile populations
type: Review
unique-id: WOS:000369718800006
usage-count-last-180-days: '0'
usage-count-since-2013: '22'
volume: '10'
web-of-science-categories: Immunology; Infectious Diseases
year: '2015'