Caught in a Web of Multiple Jeopardy: Post-Traumatic Stress Disorder and HIV-Positive Asylum Seekers in Scotland

Abstract

Many HIV-positive asylum seekers have experienced multiple traumas and human rights violationscircumstances that engender posttraumatic stress disorder (PTSD). This qualitative study examines the impact of PTSD symptoms among HIV-positive asylum seekers in Scotland. Data were collected from 19 participants, using open-ended interviews, and narrative analysis was used to develop significant themes. All respondents had significant traumatic experiences, such as physical and sexual assault, witnessing the beating and death of a loved one, and being forced to participate in the sex trade. Many experienced multiple symptoms of PTSD, including re-experiencing of intrusive thoughts, flashbacks, avoidance, and arousal. These symptoms met the duration and impairment requirements for DSM-5 diagnosis of PTSD. Their symptoms impacted their ability to tell their stories convincingly when interviewed by immigration officials. Legal processes for asylum seeking require individuals to tell their stories but ignore the impact of trauma on their ability to do so, thus increasing the likelihood of their applications being rejected. The findings indicate the need for asylum seekers to have routine assessment and treatment for PTSD and the provision of appropriate therapeutic and advocacy services.

HIV, Human Rights and Migration: Narratives of HIV-Positive Asylum Seekers in Scotland

“…Thus, despite the protection afforded by international human right laws, a narrow interpretation can result in many people being denied these rights. Accordingly, many asylum seekers continue to be directly discriminated against, particularly HIV-positive asylum seekers (Davies, 2006;Palattiyil & Sidhva, 2015. Ironically, the 2005 ruling was judged on the premise that the person was not at a 'terminal stage' of illness; however, the person's state of health was due to the HIV treatment accessed within the UK (Bettinson & Jones, 2007).…”

“…Current research on the experiences of HIV-positive asylum seekers in Scotland is relatively limited and those living with HIV are a truly hidden population (Palattiyil & Sidhva, 2015; even an invitation to participate in research is often met with reluctance owing to the fear of being exposed as HIV-positive and resultant stigma. Against this backdrop, this paper aims to explore the lived experiences of asylum seekers, living with HIV in Scotland, seen through the lens of human rights.…”

Health needs and challenges of women and children in Uganda’s refugee settlements: Conceptualising a role for social work

“…Social workers should carry out counselling and provide psychological services to refugee women and children to help them deal with trauma and post-traumatic stress disorder. This support is also an essential element for empowering those who might have to disclose their stories to the authorities during legal processes (Palattiyil and Sidhva, 2011).…”

“…The specific health issues in refugee situations have been widely covered in the literature. For example, psychological and mental health (Ssenyonga et al, 2012;Stark et al,2015;Thomas et al, 2010;Refugee Law Project, 2015;Ewles & Simnett, 2003;Hiegel, 1991;Smyke, 1991;Karunakara et al 2004;UNHCR, 2014); HIV/AIDS (IOM, 2009;Nyanzi, 2013;Palattiyil & Sidhva, 2015;Palattiyil & Sidhva, 2011;Wakabi, 2008); reproductive health (Mulumba, 2011;Mulumba & Wendo 2009;Crawley, 2001;WHO, 2015;Carey-Wood et al, 1995;Orach et al, 2007); and the physical and social wellbeing aspects (Cohen et.al, 2000;Chen & Land, 1986;Weiss & Lonnquist, 2003;WHO, 2010;WHO, 2016;Vingilis & Sarkella, 1997). In addition, there are studies which have focused on the gendered health needs of refugees such as violence against women and children in refugee situations (Deacon & Sullivan, 2009;Paoliso et al, 1995;Comas-Diaz & Jansen, 1995;WHO, 2016;WHO, 2015;Wakabi, 2008;Ewles & Simnett, 2003;WHO, 2007;Merry et al, 2011).…”

“…The specific health issues in refugee situations have been widely covered in the literature: for example, psychological and mental health (Ewles and Simnett, 2003; Hiegel, 1991; Karunakara et al, 2004; Refugee Law Project, 2015; Smyke, 1991; Ssenyonga et al, 2012; Stark et al, 2015; Thomas et al, 2010; United Nations High Commissioner for Refugees [UNHCR], 2014), HIV/AIDS (IOM, 2009; Nyanzi, 2013; Palattiyil and Sidhva, 2011, 2015; Wakabi, 2008), reproductive health (Carey-Wood et al, 1995; Crawley, 2001; Mulumba, 2011; Mulumba and Wendo, 2009; Orach et al, 2007; WHO, 2015a, 2015b) and physical and social wellbeing aspects (Chen and Land, 1986; Cohen et al, 2000; Vingilis and Sarkella, 1997; Weiss and Lonnquist, 2003; WHO, 2010, 2016). In addition, there are studies that have focused on the gendered health needs of refugees, such as violence against women and children in refugee situations (Comas-Diaz and Jansen, 1995; Deacon and Sullivan, 2009; Ewles and Simnett, 2003; Merry et al, 2011; Paolisso and Leslie, 1995; WHO, 2016; Wakabi, 2008; WHO, 2007, 2015a, 2016).…”