1. HIV Testing of Migrant and Mobile Populations in Asia Amara T. Quesada Action for Health Initiatives, Inc./ CARAM Asia

2. “Most HIV positives in our country are migrant workers. You are the ones bringing the virus to our country. So the best thing you could do is to get out of Singapore to avoid transmitting the virus.” (Doctor to a domestic worker in Singapore)

3. HIV Testing Policies Origin Countries in Asia –No compulsory testing –HIV testing with consent, confidentiality and testing –Varying degrees of access to treatment, care and support –Some countries may deport foreigners when their HIV positive status become known

4. HIV tests as experienced by Migrants Often done without knowledge or consent Conducted without pre-test and post-test counseling Results disclosed to recruitment agencies May or may not have referral to treatment, care and support

5. HIV Testing Policies Most Destination Countries –Health certificate, including HIV negative test result, required for work or residence visa –HIV test conducted among migrant workers on arrival and at regular intervals –HIV positive result leads to deportation as soon as possible

6. HIV tests as experienced by Migrants Often done without knowledge or consent Conducted without pre-test and post-test counseling Results disclosed to Immigration, employers, police HIV positive results mean detention and/or deportation No referral to services

7. The Experience of Migrants Jerry underwent HIV testing in Dubai. When he tested positive for HIV he was detained for more than a month in a hospital ward that was guarded by the police. Nobody even told him why he was there. He was eventually deported.

8. Rationale for Mandatory HIV Testing Safeguarding public health Avoiding undue economic burden on the government

9. Implications of Scaling Up HIV Testing and Counseling Considering the current contexts of migrants.. May rationalize mandatory testing policies Does not respond to the issue of deportation Does not respond to the issue of lack of access to treatment, care and support

10. Recommendations Remove mandatory testing policies for migrants Eliminate health-related deportation practices Scale up HIV preventive education for migrants Institute ‘migrant-friendly’ HIV testing policies

11. Migrant-friendly HIV Testing Voluntary Abides by international HIV testing guidelines Leads to access to treatment, care and support

12. Thank you very much!