A study of HIV positive undocumented African migrants' access to health services in the UK

Abstract

Newly immigrated persons, whatever their origin, tend to fall in the lower socioeconomic levels. In fact, failure of an asylum application renders one destitute in a large proportion of cases, often resulting in a profound lack of access to basic necessities. With over a third of HIV positive failed asylum seekers reporting no income, and the remainder reporting highly limited resources, poverty is a reality for the vast majority. The purpose of the study was to determine the basic social processes that guide HIV positive undocumented migrant's efforts to gain health services in the UK. The study used the Grounded Theory Approach. Theoretical saturation occurred after 16 participants were included in the study. The data included reflections of the prominent factors related to the establishment of a safe and productive life and the ability of individuals to remain within the UK. The data reflected heavily upon the ability of migrants to enter the medical care system during their asylum period, and on an emerging pattern of service denial after loss on immigration appeal. The findings of this study are notable in that they have demonstrated sequence of events along a timeline related to the interaction between the asylum process and access to health-related services. The results reflect that African migrants maintain a degree of formal access to health services during the period that they possess legal access to services and informal access after the failure of their asylum claim. The purpose of this paper is to examine the basic social processes that characterize efforts to gain access to health services among HIV positive undocumented African migrants to the UK. The most recent estimates indicate that there are a total of 618,000 migrants who lack legal status within the UK. Other studies have placed the number of undocumented migrants within the UK in the range of 525,000-950,000. More than 442,000 are thought to dwell in the London metropolitan area. Even in cases where African migrants enter the UK legally, they often face considerable difficulty in their quest to gain legal employment due to barriers inherent to the system that grants work permits. With over a third of HIV positive failed asylum seekers reporting no income, and the remainder reporting highly limited resources, poverty is a reality for the vast majority.

The negative health effects of hostile environment policies on migrants: A cross-sectional service evaluation of humanitarian healthcare provision in the UK

“…Our findings are significant in highlighting the multiple and likely intersecting characteristics which may contribute to marginalisation and exclusion, such as poverty and precarious immigration status/undocumentation. The results are consistent with a number of recent studies in Europe concerning the characteristics of undocumented migrants and their healthcare needs 14, 15 . The Médecins du Monde Observatory Report, which included 43,286 individuals, found that more than half of those reporting ‘fear of arrest’ as an obstacle to seeking healthcare, were in the UK 12 .…”

Are European HIV cohort data within EuroCoord representative of the diagnosed HIV population?

“…As previously described [5], women were also slightly underrepresented in most cohorts. In accordance with previous studies that report suboptimal access to care among migrants, there were indications that migrants were underrepresented [24,25]. Individuals with low CD4 + cell counts were less likely to be included in most cohorts, possibly because they may die shortly after their diagnosis, or because they often start combined antiretroviral treatment (cART) immediately and are perhaps excluded from cohorts recruiting cART-naïve individuals (e.g.…”

A systematic literature review of reported challenges in health care delivery to migrants and refugees in high-income countries - the 3C model

“…4Extension of the 3C model, summarizing the main context challengesFigure 4) [53]. First, legal aspects have a considerable influence in many settings as shown by migrants and refugees views’ that citizenship is a prerequisite to access health care [34, 37, 40]. Reciprocally, concerns about legal status affected their health and wellbeing [28, 36, 39].…”