hiv vulnerabilities of asian migrant workers: sustaining the response
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Action for Health Initiatives (ACHIEVE), Inc. HIV Vulnerabilities of Asian Migrant Workers: Sustaining the Response. Malu S. Marin ACHIEVE, Inc./ CARAM-Asia. CARAM Asia. Action for Health Initiatives (ACHIEVE), Inc. It Figures…. - PowerPoint PPT PresentationTRANSCRIPT
Washington D.C., USA, 22-27 July 2012www.aids2012.org
HIV Vulnerabilities of Asian Migrant Workers: Sustaining the Response
Malu S. MarinACHIEVE, Inc./CARAM-Asia
CARAM Asia
Action for Health Initiatives (ACHIEVE), Inc.
Washington D.C., USA, 22-27 July 2012www.aids2012.org
It Figures…
• Temporary labor migration towards the Middle East and, in particular, the Arab States, represents the dominant flow (estimated 28.5 million migrants).
• There are 13.2 million migrants in South East Asia and East Asia.
• 1.2 million are working in Malaysia alone. • The Philippines has an estimated 3.8 million contract workers
abroad and majority of these work in Asia and the Gulf States• The total remittance inflow in Asia was USD 162.5 billion in
2009 (39% of total global remittances).
Action for Health Initiatives (ACHIEVE), Inc.
Washington D.C., USA, 22-27 July 2012www.aids2012.org
• In the Philippines, 10% among all registered HIV cases are migrant workers (2012 data).
• In Malaysia 0.03% of migrant workers screened, tested HIV positive as of 2004.
• Cambodian migrant workers have an HIV prevalence rate of 2.5 %, the highest of any migrant population in Thailand.
• In Bangladesh, 47 of the 259 cases of people living with HIV between 2002-2003 were infected as a result of migration. In 2004, 57 of the 102 newly reported HIV cases were among returning migrants.
Action for Health Initiatives (ACHIEVE), Inc.
Washington D.C., USA, 22-27 July 2012www.aids2012.org
HIV Prevalence: Migrant workers in 6 high-prevalence provinces of Thailand, 2010
Male Female Total
Age 15-24 1.0% 1.4% 1.1%
All ages 1.7% 2.1% 1.9%
Source: IBBS, Ministry of Health, Bureau of Epidemiology - Thailand , 2010
Action for Health Initiatives (ACHIEVE), Inc.
Washington D.C., USA, 22-27 July 2012www.aids2012.org
• MIGRATION, in and by itself, is not a risk factor for HIV infection.
• Need to look at conditions, in which migrant workers are situated, that predispose or result to ‘risky behaviors’.– Personal factors– Socio-cultural factors– Economic factors
• Need to look at impact of HIV infection
Action for Health Initiatives (ACHIEVE), Inc.
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Initiatives on migration and HIV
Pioneered the HIV and migration response in Asia (beginning 2007).– pre-departure – post-arrival – reintegration – policy advocacy (national, regional and international)
Placed HIV and AIDS in the map of national and regional responses (18 countries)
Washington D.C., USA, 22-27 July 2012www.aids2012.org
• Began in 1997• Inclusion of HIV in national AIDS Plans
(2000 onwards)• Representation of migration in the
National AIDS Body• Integration of HIV in training curriculum of
all foreign service personnel• Sporadic funding and support
Migration and HIV response in the Philippines
Washington D.C., USA, 22-27 July 2012www.aids2012.org
– Multisectoral platform for regional advocacy on migration and HIV
– Country score card / diagnostics card on access to health for migrant workers in the ASEAN Region
– High-level multi-stakeholder dialogues on migration and HIV
– Facilitating in-country support
Action for Health Initiatives (ACHIEVE), Inc.
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Challenges• Political issue– issue of rights, citizenship,
security, public health• ‘Migration and HIV’ is slipping off
in the agenda of country responses and the UN
• Evidence-based programming is hampered by ‘absence of epidemiological data’
Action for Health Initiatives (ACHIEVE), Inc.
Washington D.C., USA, 22-27 July 2012www.aids2012.org
• Migrants fall into the cracks of health care systems of their countries of origin and destination
• Migrant workers are not a homogeneous group– No interaction with key
populations, e.g. sex workers, MSM, IDU, etc.
Action for Health Initiatives (ACHIEVE), Inc.
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Lessons learned • Partnerships across the migration continuum• Community involvement • Address policy barriers • Need to frame migration as a context, rather than a risk
factor• Need to look at KPHR in the context of migration or how
risky/unsafe behaviors occur in the context of migration• Address gender and sexuality issues in the context of
migration.
Action for Health Initiatives (ACHIEVE), Inc.
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Action for Health Initiatives (ACHIEVE), Inc.