Rise in mobility across South-East Asia puts millions more at risk for HIV – UN report

The growing number of people crossing boundaries in South-East Asia searching for economic opportunity puts millions at risk to HIV infection with little or no protection or access to services, according to a United Nations report launched today.

A country-by-country assessment of HIV and mobility in the 10 Association of Southeast Asian Nations (ASEAN) countries revealed that, despite their contributions to national economies, migrants lack legal and social rights and generally have no access to HIV/AIDS medical and information services.

“Migrant workers are a vital force to national economies in South-East Asia, yet when it comes to protecting their rights and ensuring HIV prevention and treatment, they are often among the forgotten,” said UN Development Programme (UNDP) Director for Asia and the Pacific, Ajay Chhibber.

High-risk behaviour and HIV infection rates are significantly higher among migrants than in the general population, the joint UN-ASEAN report noted.

The report also indicated that HIV infection rates for migrant fishermen in Thailand were as high as 9 per cent, and at least 30 per cent of people living with HIV in the Philippines and Laos were returning migrants.

Most migrants are not covered by national AIDS programmes and their services, according to the report. It said that in Thailand, for example, registered migrants have access to health services with subsidized medical costs, but anti-retroviral (ARV) treatment is not included. If migrants are found to be HIV-positive through routine testing in Malaysia, Singapore and Brunei, they are repatriated.

Although Indonesia has shown a commitment to addressing HIV vulnerability among mobile populations with their inclusion in national HIV prevention, care and treatment strategies and with policies prohibiting mandatory HIV testing during recruitment processes, limited HIV infection rate data exists for these populations.

Cambodia, Indonesia, Laos, the Philippines and Viet Nam have also made attempts to tackle the risk faced by migrants by developing “pre-departure training” on HIV prevention for outbound migrant workers, but the report concludes that this has been largely ineffective as the courses are offered too late in the moving process and are too short in duration.

The report makes a number of recommendations to policymakers as they respond to the challenge of the growing numbers of migrant populations who are at greater risk to HIV than people who stay in their home countries.

The report’s recommendations include developing gender-sensitive epidemiological data, strengthening cooperation to ensure a continuation of services for migrants, coordinating cross-border HIV efforts, allocating adequate financial and human resources to address migrant needs, and reinforcing policies and commitments on HIV/AIDS.