Free Content Migrants’ access to antiretroviral therapy in Thailand

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Abstract:

Summary Objective  To investigate migrants’ access to antiretroviral therapy (ART) and assess the applicability of ART guidelines to migrants. Methods  Six focus group discussions (FGD) were conducted in Thailand with 74 Burmese migrants: factory workers in Mae Sot and Bangkok, construction site workers in Chiang Mai and unemployed and undocumented HIV-positive migrants in Mae Sot. Thirteen key stakeholders and migrants were interviewed for triangulation. Results  (1) Present criteria for in-/exclusion restrict migrants’ access to ART. (2) Leading ART guidelines are not applicable for migrants in general. (3) Migrants are likely to experience more problems with adherence to ART than local patients, which increases the importance of ART guidelines. Conclusions  Without ART guidelines that take into consideration the specific circumstances that limit migrants’ access to ART, health care providers will continue to render HIV-positive migrants ineligible. Interventions are needed to both make the ART guidelines applicable to migrants and to overcome obstacles restricting migrants’ access to ART. This will greatly improve migrants’ access to ART and help to save the lives of thousands of HIV-positive migrants.

French
Objectif 

Investiguer l'accès des migrants au traitement antirétroviral (ART) et évaluer l'applicabilité des directives du ART aux migrants. Méthodes 

Six discussions de groupe focalisées ont été menées en Thaïlande avec 74 migrants birmans comprenant des ouvriers d'usine à Mae Sot et à Bangkok, des ouvriers de chantier de construction à Chiang Mai et des migrants VIH positifs sans emploi et non documentés à Mae Sot. Treize dépositaires et migrants principaux ont été interviewés pour la triangulation. Résultats 

(1) les critères actuels pour l'inclusion/exclusion limitent l'accès du ART aux migrants. (2) les principales directives du ART ne sont en général pas applicables aux migrants. (3) les migrants sont susceptibles d'avoir plus de problèmes d'adhérence au ART que les patients locaux, ce qui souligne l'importance des directives du ART. Conclusions 

Sans directives pour le ART qui prennent en compte les circonstances spécifiques limitant l'accès des migrants au ART, les pourvoyeurs de soin continueront à considérer les migrants VIH positifs comme inéligibles. Des interventions sont nécessaires pour rendre les directives du ART applicables aux migrants et pour surmonter les obstacles limitant l'accès des migrants au ART. Cela améliorera considérablement l'accès des migrants au ART et aidera à sauver les vies de milliers de migrants VIH positifs.

Keywords: ART; ART guidelines; TAR; Tailandia; Thailand; Thaïlande; accesos; access; accès; antiretroviral; directives du ART; emigrantes; migrants; pautas de TAR

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1365-3156.2007.01879.x

Affiliations: 1:  VU University Medical Centre, Section Health Care and Culture, Amsterdam, The Netherlands 2:  Thai Labour Campaign, Bangkok, Thailand

Publication date: August 1, 2007

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