Dataset Information

HIV testing policies for migrants and ethnic minorities in EU/EFTA Member States.

ABSTRACT:

Background

In the context of an European Centre for Disease Prevention and Control (ECDC) research project, our objective was to describe current recommendations regarding HIV testing and counselling targeting migrants and ethnic minorities in the European Union/European Economic Area/European Free Trade Association (EU/EEA/EFTA) Member States.

Methods

An on-line survey was conducted among 31 EU/EEA/EFTA Member States. The survey inquired on the existence of specific HIV testing and counselling recommendations or policies for migrants and/or ethnic minorities and the year of their publication. Additionally, we performed a review of national recommendations, guidelines or any other policy documents retrieved from an Internet search through the different countries' competent bodies.

Results

Twenty-nine (94%) country representatives responded the survey, and 28 documents from 27 countries were identified. National guidelines on HIV testing are heterogeneous and tailored, according to the epidemiological situation. Twenty-two countries identify migrants and four countries identify ethnic minorities as particularly vulnerable to HIV. Sixteen countries explicitly recommend offering an HIV test to migrants/ethnic minorities. Guidelines especially target people originating from HIV endemic countries, and benefits of HIV early detection are highlighted. HIV testing is not mandatory in any country, but some countries overtly facilitate this practice.

Conclusion

Benefits of HIV testing in migrants and ethnic minorities, at both individual and community levels are recognized by many countries. In spite of this, not all countries identify the need to test these groups.

SUBMITTER: Alvarez-Del Arco D

PROVIDER: S-EPMC3901314 | biostudies-literature | 2014 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

HIV testing policies for migrants and ethnic minorities in EU/EFTA Member States.

Alvarez-Del Arco Debora D Monge Susana S Caro-Murillo Ana M AM Ramírez-Rubio Oriana O Azcoaga-Lorenzo Amaya A Belza Maria J MJ Rivero-Montesdeoca Yaiza Y Noori Teymur T Del Amo Julia J

European journal of public health 20130805 1

<h4>Background</h4>In the context of an European Centre for Disease Prevention and Control (ECDC) research project, our objective was to describe current recommendations regarding HIV testing and counselling targeting migrants and ethnic minorities in the European Union/European Economic Area/European Free Trade Association (EU/EEA/EFTA) Member States.<h4>Methods</h4>An on-line survey was conducted among 31 EU/EEA/EFTA Member States. The survey inquired on the existence of specific HIV testing a ...[more]

PMID: 23921295

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Project description:BackgroundIn Europe, progress in the development of health policies that address the needs of migrants and ethnic minorities has been slow. This is partly due to the absence of a strategic commitment by the health authorities. The Ministry of Public Health commissioned the ETHEALTH (EThnicity &HEALTH) group to formulate relevant recommendations to the public authorities with a view to reducing health inequalities among ethnic minorities. This paper describes the political process and the outcomes of the ETHEALTH expert group.ResultsAfter ten meetings, the ETHEALTH group came up with 46 recommendations, which were presented at a national press conference in December 2011. Target groups concerned by these recommendations covered both irregular migrants and migrants entitled to the national insurance coverage. Recommendations were supported by the need of combining universal approaches to health care with more specific approaches. The scope of the recommendations concerned health care as well as prevention, health promotion and access to health care. When analysing the content of the recommendations, some ETHEALTH recommendations were not fully measurable, and time-related; they were, however, quite specific and realistic within the Belgian context. The weak political commitment of an executive agency was identified as a major obstacle to the implementation of the recommendations.ConclusionsThe ETHEALTH group was an example of scientific advice on a global health issue. It also demonstrated the feasibility of coming up with a comprehensive strategy to decrease ethnic health inequalities, even in a political context where migration issues are sensitive. Two final lessons may be highlighted at the end of the first phase of the ETHEALTH project: firstly, the combination of scientific knowledge and practical expertise makes recommendations SMART; and, secondly, the low level of commitment on the part of policymakers might jeopardise the effective implementation of the recommendations.

Project description:Provider-initiated HIV testing (PITC) is increasingly adopted in Europe. The success of the approach at identifying new HIV cases relies on its effectiveness at testing individuals most at risk. However, its suitability to reach populations facing overlapping vulnerabilities is under researched. This qualitative study examined HIV testing experiences and perceptions amongst Latin-American migrant men who have sex with men and transgender females in Spain, as well as health professionals' experiences offering HIV tests to migrants in Barcelona and Madrid.We conducted 32 in-depth interviews and 8 discussion groups with 38 Latin-American migrants and 21 health professionals. We imported verbatim transcripts and detailed field work notes into the qualitative software package Nvivo-10 and applied to all data a coding framework to examine systematically different HIV testing dimensions and modalities. The dimensions analysed were based on the World Health Organization "5 Cs" principles: Consent, Counselling, Connection to treatment, Correctness of results and Confidentiality.Health professionals reported that PITC was conceptually acceptable for them, although their perceived inability to adequately communicate HIV+ results and resulting bottle necks in the flow of care were recurrent concerns. Endorsement and adherence to the principles underpinning the rights-based response to HIV varied widely across health settings. The offer of an HIV test during routine consultations was generally appreciated by users as a way of avoiding the embarrassment of asking for it. Several participants deemed compulsory testing as acceptable on public health grounds. In spite of--and sometimes because of--partial endorsement of rights-based approaches, PITC was acceptable in a population with high levels of internalised stigma.PITC is a promising approach to reach sexual minority migrants who hold high levels of internalised stigma but explicit extra efforts are needed to safeguard the rights of the most vulnerable.

Project description:BackgroundThere are widespread concerns that ethnic minorities and migrants may have inadequate access to COVID-19 vaccines. . Improving vaccine uptake among these vulnerable groups is important towards controlling the spread of COVID-19 and reducing unnecessary mortality. Here we perform a systematic review of ethnic minorities' and migrants' access to and acceptance of COVID-19 vaccines.MethodsWe searched PubMed and Web of Science databases for papers published between 1 January 2020 and 7 October 2021. Studies were included if they were peer-reviewed articles; written in English, included data or estimates of ethnic minorities' or migrants' access to vaccines; and employed either qualitative or quantitative methods. Of a total of 248 studies screened, 33 met these criteria and included in the final sample. Risk of bias in the included studies was assessed using Newcastle Ottawa Scale and Critical Appraisal Skills Program tools. We conducted a Synthesis Without Meta-analysis for quantitative studies and a Framework synthesis for qualitative studies.Results31 of the included studies were conducted in high-income countries, including in the US (n = 17 studies), UK (n = 10), Qatar (n = 2), Israel (n = 1) and France (n = 1). One study was in an upper middle-income country -China (n = 1) and another covered multiple countries (n = 1). 26 studies reported outcomes for ethnic minorities while 9 studies reported on migrants. Most of the studies were quantitative -cross sectional studies (n = 24) and ecological (n = 4). The remaining were qualitative (n = 4) and mixed methods (n = 1). There was consistent evidence of elevated levels of COVID-19 vaccine hesitancy among Black/Afro-Caribbean groups in the US and UK, while studies of Hispanic/Latino populations in the US and Asian populations in the UK provided mixed pictures, with levels higher, lower, or the same as their White counterparts. Asians in the US had the highest COVID-19 vaccine acceptance compared to other ethnic groups. There was higher vaccine acceptance among migrant groups in Qatar and China than in the general population. However, migrants to the UK experienced barriers to vaccine access, mainly attributed to language and communication issues. Lack of confidence, mainly due to mistrust of government and health systems coupled with poor communication were the main barriers to uptake among Black ethnic minorities and migrants.ConclusionsOur study found that low confidence in COVID-19 vaccines among Black ethnic minorities driven by mistrust and safety concerns led to high vaccine hesitancy in this group. Such vaccine hesitancy rates constitute a major barrier to COVID-19 vaccine uptake among this ethnic minority. For migrants, convenience factors such as language barriers, fear of deportation and reduced physical access reduced access to COVID-19 vaccines. Building trust, reducing physical barriers and improving communication and transparency about vaccine development through healthcare workers, religious and community leaders can improve access and facilitate uptake of COVID-19 vaccines among ethnic minority and migrant communities.

Project description:The European Green Deal (EGD) aims to transform the European Union (EU) into a climate neutral continent by 2050, requiring significant changes within carbon-intensive sectors. In this article, we examine EU Member States’ climate strategies in the aviation sector, where greenhouse gas emissions have doubled since 1990. We analyse EU National Energy and Climate Plans (NECPs) in order to examine national commitments on aviation. How frequently do EU Member States refer to aviation in their NECPs, and how can these references be understood thematically? First, by conducting a content analysis on all 54 draft and final NECPs, we identify how frequently 11 aviation-related terms were used. While all states increased the number of aviation references between their draft and final NECPs, Central and Eastern states showed the smallest increase. We show that Southern and Western Member States reference aviation most frequently in their final NECPs. Second, in our thematic analysis, we identify three key themes—‘contextual information’, ‘public policy’, and ‘fuels and propulsion’—that we divide into 17 sub-themes. Approximately half of the themes focused on contextual information, such as current aviation emissions, with the other half focusing on carbon reduction strategies, especially the EU Emissions Trading System, biofuels, and taxation. Western EU states provided the largest number of concrete policy statements on reducing aviation emissions and the promotion of biofuels. There were only two references to reducing the number of flights, across almost 7500 pages of climate documents. We conclude that the NECPs represent a promising means of conducting cross-country climate policy analysis, in order to compare efforts across economic sectors within Europe. With our analysis, we create a pre-pandemic sectoral baseline for aviation which can be used for further study. Supplementary Information The online version contains supplementary material available at 10.1007/s44168-022-00018-1.

Dataset Information

HIV testing policies for migrants and ethnic minorities in EU/EFTA Member States.

Background

Methods

Results

Conclusion

Publications

HIV testing policies for migrants and ethnic minorities in EU/EFTA Member States.

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