Dr Elhadji MBAYE Science po Grenoble/ IRD/ U. Montreal

Introduction 1. Aids and migration in Europe is an issue between rich and poor countries. 2. Heterogenenous contribution of migrants in European countries HIV epidemic. 3. Aids among migrants in Europe do not concern only those coming from SSA. Focus on Aids among Black migrants coming from SSA in Europe.

Aids among SSA in Europe 1. Heterosexual infections 2. Feminisation 3. Late HIV/Aids Diagnosis 4. Socioeconomic issues 5. Cutural competences

Feminisation of Aids among SSA migrants From 1999 to 2006, 41% of new cases HIV reported infected through MTC in Europe were from SSA. Their vulnerability is both social and biological bases. Affected by gender inequalities, stigmatisation, isolation… Substantial challenges are needed to improve their living conditions as migrants, women, black, LHIV: four vulnerabilities!

Who are migrants LHIV en Europe? Undocumented migrants : « illegal migrants », « Sans papiers » : those without any legal residence in the country in which they are living Legal migrants : those who have a permit card to stay and move in Europe Foreigners : those who have an other nationality Asylum seekers, refugees : protected by the Geneva convention Immigrants: born foreigner in an other country « Ethnic minorities », migrants : grouping those who have a migrant background (natives whose parents are migrants, immigrants…) Vulnerability to HIV/Aids and access to health care and to a resident permit depend whether MLIH are in one of these categories.

Changes of political and research paradigms A risky approach A public health approach A contain and control Strategy A cooperation and inclusion approach A SES approach Racial and Ethnic minorties approach

Access to healthcare for UM (PICUM, MDM) 1/3 of UM in Europe are unaware of their rights to healthcare. 70% of theoretical beneficiaries do not have access to healthcare. The main actions must be to encourage EU states to respect the International and European conventions guarantying access to heathcare for all human beings condemning xenophobia and racism.

Theoretical and effective access to health (MDM) Proportion of out of status people with theoretical and effective access to free healthcare Obstacles in accessing care

UM and HIV : unawareness of health services available (MDM, 2006) Frequency of unawareness of free HIV screening Frequency of unawareness of free HIV treatments

Criminalisation of HIV Transmission by SSA migrants  Prosecutions of migrants from Sub-Saharan Africa in a lot of European countries. The helpful role of the media. Its consequences in violating human rights : lack of effective care, imprisonment, internment in detention centres, deportations…

Deportation of African migrants living with HIV/Aids In Europe, migrants LAIDS can be protected against deportation by article 3 of ECHR. BUT because of restrictive interpretations of this article… a lot of deportations In UK In France and others countries… Result : People are convicted to death when they are deported in countries without accessible treatment!

Human rights instead of humanitarian Not a Humanitarian political approach But : 1. Human rights. 2. Public health approach. 3. Fighting against health inequalities

Positive aspects The decrease of infections among migrants… The increase of Aids programmes targeting migrants The mobilization of CBOs The mobilsation of NGOs The mobilisation of European research and political networks

Conclusion Curry on fighting against misconceptions Stop linking immigration control policies with fighting against aids programmes Curry on reinforcing social mobilization against Aids involving migrants as stakeholders