Improved Transnational HIV Care Needed for Deported Immigrants

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The transnational coordination of care for HIV must be strengthened to prevent poor health outcomes as immigrants are deported from the United States.
The transnational coordination of care for HIV must be strengthened to prevent poor health outcomes as immigrants are deported from the United States.

As more immigrants from Latin America are detained and deported from the United States, the transnational coordination of care for HIV must be strengthened to prevent poor health outcomes, according to a viewpoint published in Lancet HIV.

As the US Immigration and Customs Enforcement has increased anti-immigrant rhetoric and arrests, more patients have begun to ask about the availability of HIV treatment in their home countries. Although antiretroviral therapy is available throughout Latin America, access to treatment is affected by economic, social, and political circumstances.

To maintain continuity of HIV care for immigrants during deportation proceedings, the researchers issued several recommendations.

Detention centers in the United States that detain immigrants should have monitoring systems to ensure that all facilities are adhering to performance-based national standards for the delivery of adequate care.

If detention centers cannot adequately meet certain medical needs, community-based alternatives and humanitarian parole could be offered.

The researchers also call for improved methods of data collection and identification of deportees infected with HIV that are compliant with patient autonomy and protection of confidentiality.

To ensure continuity of transnational HIV care, legally and ethically sound data-sharing policies must be developed to strengthen the coordination of care between countries.

The researchers stressed that without interventions, increased deportations can lead to thousands of individuals at risk for treatment interruption, poor health outcomes, and ongoing transmission between receiving communities at the US-Mexico border.

"A systems approach to address the transnational continuity of HIV care would have broad benefits not only for undocumented immigrants, but also for global public health and for all HIV-infected individuals who choose to relocate abroad, regardless of country of origin or destination," the researchers wrote.

Reference

Page KR, Grieb SD, Nieves-Lugo K, et al. Enhanced immigration enforcement in the USA and the transnational continuity of HIV care for Latin American immigrants in deportation proceedings [published online July 8, 2018]. Lancet HIV. doi: 10.1016/ S2352-3018(18)30074-2

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