Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Lancet HIV. 2018 Oct;5(10):e597-e604. doi: 10.1016/S2352-3018(18)30074-2. Epub 2018 Jul 8.
In our work as clinicians, researchers, and immigrant rights advocates, we have noted increased anxiety about the possibility of deportation and disruptions in care among immigrants with HIV. Before the 2016 US elections, patients rarely asked about HIV treatment in their home countries. However, since the increase in anti-immigrant rhetoric and arrests by US Immigration and Customs Enforcement, patients have voiced concerns about the availability of HIV treatment in their home countries much more frequently. Although antiretroviral therapy is available throughout Latin America, access depends on economic, social, and political circumstances. Maintaining uninterrupted continuity of care among immigrants held in detention or deported to their home countries is challenging. In this Viewpoint, we identify periods of particular vulnerability for immigrants during deportation proceedings, from initial detention to deposition in their country of origin. We discuss the effect of enhanced immigration enforcement on the health and wellbeing of HIV-infected immigrants, and on public health. Finally, we also discuss recommendations for clinicians, immigration authorities, and public health institutions in the USA and in receiving countries.
在我们作为临床医生、研究人员和移民权利倡导者的工作中,我们注意到感染艾滋病毒的移民对被驱逐出境和医疗服务中断的可能性感到更加焦虑。在 2016 年美国大选之前,患者很少询问有关其原籍国的艾滋病毒治疗问题。然而,自反移民言论增加和美国移民和海关执法局(US Immigration and Customs Enforcement)逮捕以来,患者更加频繁地表示担心其原籍国的艾滋病毒治疗的可及性。尽管抗逆转录病毒疗法在整个拉丁美洲都有提供,但获得治疗的机会取决于经济、社会和政治情况。维持被拘留或被驱逐到原籍国的移民的医疗服务不间断的连续性具有挑战性。在本观点中,我们确定了在驱逐程序期间移民特别脆弱的时期,从最初的拘留到被遣返到原籍国。我们讨论了加强移民执法对感染艾滋病毒的移民的健康和福祉以及公共卫生的影响。最后,我们还讨论了对美国和接收国的临床医生、移民当局和公共卫生机构的建议。