Sabina Haberlen

This symposium discussed the heightened risks for HIV acquisition and challenges to accessing HIV services amongst mobile populations globally. Multilevel interventions are needed to interrupt the high levels of sexual violence experienced by women and girls among refugee and asylum-seeking populations and deliver HIV services to diverse mobile populations.

The symposium began with complementary presentations of the key issues affecting the mobile workforce in Africa for men and women, respectively. Dr. Zachary Kwena discussed barriers to care among men who migrate for work in Africa, including truck drivers, miners, and fishermen. Language barriers, economic instability, lack of information about the healthcare system, and fear of deportation due to undocumented worker status are barriers to accessing prevention and treatment services. Dr. Elizabeth Kemigisha demonstrated that while most mobile workers in Africa are men, female migrants often experience greater economic instability and are more likely to engage in transactional sex, due to limited and gendered options for generating income. Women and girls in refugee settings had high risks of sexual assault coupled with limited access to healthcare, including sexual and reproductive health. Finally, Dr. Claudia Cortes discussed the migration crisis in Latin America and the Caribbean, driven by violence, wealth inequality, and limited provision of public services, including HIV treatment, in countries with high out-migration. Destination countries are expanding HIV coverage, e.g. migrants from Venezuela comprised 15% of new HIV cases in Columbia and migrants from Haiti comprised half of new HIV cases in the Dominican Republic.

Migrants are a heterogenous group including those who move for economic opportunity and those displaced by war, natural disasters, or other threats in their origin country. Across the different populations and regions discussed, the elevated risk of HIV acquisition and lack of access to care were common themes echoed throughout the session. PEPFAR funding was noted as a key to enabling the expansion of HIV treatment for the large number of migrants in Latin America. Meeting the health needs of mobile populations will require both multistate collaborations, such as the Quito Process, and interventions to reach diverse migrant populations.