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• W2913491859 abstract "A recent British Association of Sexual Health and HIV (BASHH)/British HIV Association (BHIVA) statement highlighted the potential deleterious public health effects of changes to overseas visitor's charges in the UK1British Associaton for Sexual Health & HIVBASHH & BHIVA response to Formal Review of ‘The National Health Service (Charges to Overseas Visitors) (Amendment) Regulations 2017.https://www.bashh.org/news/news/bashh-bhiva-response-to-formal-review-of-the-national-health-service-charges-to-overseas-visitors-amendment-regulations-2017/Date accessed: January 17, 2019Google Scholar on both HIV prevention and care and sexual and reproductive health. Until recently, data sharing between NHS Digital and the Home Office had been another deterrent to migrants accessing health care.2Campbell D NHS will no longer have to share immigrants' data with Home Office.The Guardian. 2018; https://www.theguardian.com/society/2018/may/09/government-to-stop-forcing-nhs-to-share-patients-data-with-home-officeDate accessed: January 17, 2019Google Scholar The proportion of people living with HIV in England who are successfully treated on antiretroviral therapy is extremely high and is based on a confidential service that is free at the point of access. Rates of vertical transmission are just 0·27%.3Peters H Francis K Sconza R et al.UK mother-to-child HIV transmission rates continue to decline 2012–2014.Clin Infect Dis. 2017; 64: 527-528PubMed Google Scholar A report by Doctors of the World indicates that charging is likely to deter hard to access groups from care.4Doctors of the WorldDeterrence, delay and distress: the impact of charging in NHS hospitals on migrants in vulnerable circumstances.https://www.doctorsoftheworld.org.uk/wp-content/uploads/import-from-old-site/files/Research_brief_KCL_upfront_charging_research_2310.pdfDate accessed: January 17, 2019Google Scholar Although communicable diseases are exempt from charging, there is substantial confusion surrounding health-care eligibility, both among patients and professionals.5Medact Manchester report: Healthcare professionals' views and experiences of dealing with refugees and asylum seekers: a survey of North West practitioners.https://medactmanchester.files.wordpress.com/2017/10/medact_report_2017.pdfDate accessed: January 17, 2019Google Scholar Vital opportunities for the diagnosis of communicable disease in other, chargeable health-care settings are lost by deterring access. The ANRS-PARCOURS study showed that, about a third of HIV positive sub-Saharan African migrants or refugees in France acquired HIV after migration. Indicators of social hardship (housing, immigration status, homelessness) were significantly associated with HIV acquisition. Those who had experienced non-volitional and transactional sex were also more likely to be HIV positive.6Desgrees-du-Lou A Pannetier J Ravalihasy A et al.Is hardship during migration a determinant of HIV infection? Results from the ANRS PARCOURS study of sub-Saharan African migrants in France.AIDS. 2016; 30: 645-656Crossref PubMed Scopus (53) Google Scholar Women, men, and unaccompanied asylum-seeking children may experience sexual and gender-based violence in their country of origin and en route to or in the UK.7Finnerty F Shahmanesh M Sexual and reproductive health in the European refugee crisis.Sex Transm Infect. 2016; 92: 485-486Crossref PubMed Scopus (8) Google Scholar Men who have sex with men are particularly at risk of HIV acquisition after migration.8Fayoka I Alvarez del Arco D Woode-Owusu M et al.A systematic review of post-migration acquisition of HIV among migrants from countries with generalised HIV epidemics living in Europe: Implications for effectively managing HIV prevention programmes and policy.BMC Public Health. 2015; 15: 561Crossref PubMed Scopus (86) Google Scholar Based on these findings, migrants in the UK might be at increased risk of HIV and sexually transmitted infections. Antenatal care is not exempt from charges and neither is termination of pregnancy.9UK GovernmentNHS visitor and migrant cost recovery programme.https://www.gov.uk/government/publications/guidance-on-overseas-visitors-hospital-charging-regulations/summary-of-changes-made-to-the-way-the-nhs-charges-overseas-visitors-for-nhs-hospital-careDate accessed: January 17, 2019Google Scholar These charges will deter pregnant women from accessing services and could affect the rate of vertical transmission of HIV. They could also result in unsafe termination of pregnancy. Charging of overseas visitors alters the health environment significantly, in line with the UK Government's hostile environment policy.10Taylor D Rights groups decry Theresa May's ‘hostile environment’ immigration policy.The Guardian. 2018; https://www.theguardian.com/uk-news/2018/apr/09/rights-groups-decry-theresa-may-hostile-environment-immigration-policyDate accessed: January 17, 2019Google Scholar We believe these charges will serve as a deterrent for migrants wishing to access health care for conditions for which control is a significant good, not only to the individual but for the health of the population. The authors welcome the proposal to amend the Memorandum of Understanding, which requires NHS data-sharing with the Home Office,2Campbell D NHS will no longer have to share immigrants' data with Home Office.The Guardian. 2018; https://www.theguardian.com/society/2018/may/09/government-to-stop-forcing-nhs-to-share-patients-data-with-home-officeDate accessed: January 17, 2019Google Scholar but further work is needed to address health inequalities and to facilitate diagnosis and treatment of communicable diseases. FF has received a travel bursary from Janssen for an international exchange fellowship and is an independent advisor for Refugee Rights Europe. YA is director of strategy at the National Aids Trust., which has received grants from Gilead, Janssen, Mundipharma, and ViiV over the last 12 months. YA has received honorariums as a member of NHS England's Programme of Care Board for Blood and Infection. CO is chair and Executive trustee of the British HIV Association (BHIVA). CO reports grants, personal fees, non-financial support and other from Gilead, Janssen, AbbVie, BMS, ViiV, and MSD, outside the submitted work." @default.
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• W2913491859 title "Hostile health-care environment could increase migrants' risk of HIV and prevent access to vital services" @default.
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