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

2. 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.

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

4. Migrants are heterogeneous key populations
They have different migration drivers

6. Know your epidemic – Know your response

7. 55 countries covered by the Dublin Declaration

8. ART entitlement for undocumented migrants, 2014

9. ART entitlement for undocumented migrants 2016

11. ART access for migrants in Europe

12. 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

13. ART access for migrants in Europe

14. ART initiation recommendations

16. ART responses in migrants in Europe

17. ART responses in migrants in Europe
Immunological response
Men
Women

18. Men

19. ART responses in migrants in Europe
Virological response

22. 2013

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

24. Acknowledments