Access and response to ART among migrants

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Presentation transcript:

Access and response to ART among migrants Professor Julia del Amo National Center for Epidemiology Institute of Health Carlos III Madrid, Spain

Conflict of Interest Julia del Amo has received research grants awarded to her team from Companies BMS, MSD, Gilead, ViiV. Julia del Amo has received teaching fees from Companies MSD, Gilead, ViiV.

Outline ART entitlement ART access ART responses Conclusions Virological Immunological Mortality Conclusions Migrants in Europe

Migrants are heterogeneous key populations They have different migration drivers

Know your epidemic – Know your response

55 countries covered by the Dublin Declaration

ART entitlement for undocumented migrants, 2014

ART entitlement for undocumented migrants 2016

ART access for migrants in Europe

They undermines public health approaches for 90 90 90 Location of barriers Structural Healthcare Community levels Barriers act in synergy to limit access to, or acceptance of, HIV testing, ART uptake and responses Nature of barriers Socio-economic inequalities Legal Stigma and discrimination Cultural & linguistic & gender Psychological “low risk perception” They undermines public health approaches for 90 90 90

ART access for migrants in Europe

ART initiation recommendations

1997-2013

ART responses in migrants in Europe

ART responses in migrants in Europe Immunological response Men Women

Men

ART responses in migrants in Europe Virological response

2013

Conclusions & Action needed Fight for universal access to ART in Europe

Acknowledments