Migration to the UK has signficantly changed the nature of the HIV epidemic since many people have come from countries with high HIV prevalence. The immigration process is complex and raises a number of issues for people living with HIV.

Asylum seekers are not allowed to work to support themselves or their families, but instead have to rely on benefits which are significantly lower than basic income support. This has harmful impacts on self-respect and mental health and pushes people into near destitution and inappropriate economic dependence.

We are working with healthcare managers at both initial accommodation and removal centres for asylum seekers, as well as UK Border Agency officials, to ensure that asylum seekers living with HIV receive the best possible treatment, care and support at every stage of the asylum process. 

We oppose the deportation of anyone with HIV to a country where they will not be able easily to access HIV treatment to maintain their health.

We continue to campaign for everyone living with HIV in the UK to have access to life-saving treatment. 

The myth of HIV health tourism

Over the last few years, numerous allegations have been made about health tourism to the UK both in general and in relation to HIV. These claims have affected media and popular perception, as well as Government policy, particularly on entitlement to NHS care. But as our report clearly demonstrates there is no evidence that HIV health tourism to the UK exists. Migration has been one of the most seriously debated issues in UK politics recently. It is therefore vitally important to separate the facts and evidence around migration from the fears and misinformation.  Read our report The Myth of Health Tourism.

Asylum Pathway

In 2008 NAT published HIV and the UK Asylum Pathway.  More people than ever before are living with HIV in the UK, and a significant number of asylum seekers are coming from high prevalence countries. This report maps the process an asylum seekers goes through and makes the case for the needs of HIV-positive asylum applicants to be better supported throughout the asylum process and the HIV prevention needs of migrants to be considered earlier.

HIV and the UK Asylum Pathway is in two parts. The first section maps out the complex pathway an asylum seekers in the UK takes from application to when a decision is made on their claim. The second half of the report highlights the needs of an HIV-positive asylum seeker and identifies both challenges and opportunities professionals have to address those needs. 

The report is an ideal guide for professionals including community care nurses, GPs and civil servants, who support asylum seekers through the course of their work. 

Initial Accommodation

We reviewed what information on HIV prevention, testing and treatment is available to asylum seekers being supported in initial accommodation. Working with the UK Border Agency and other stakeholders, NAT identified potential opportunities to distribute additional sexual health and HIV-related materials, including information about the benefits of accessing voluntary testing and HIV services in the UK.  Read our report Initial Accommodation and HIV.

Dispersal

The policy of dispersing asylum seekers across the UK has resulted in people living with HIV being moved at short notice without proper arrangements for continuity of care and treatment, causing serious ill health and possible drug resistance.  In response to concerns about the dispersal of asylum seekers living with HIV, we investigated issues related to dispersal and produced a report in 2006.  Read the report Dispersal of Asylum Seekers Living with HIV.

These recommendations helped influence the introduction of new Home Office procedures for dispersal of asylum seekers with healthcare needs. Read  BHIVA/NAT advice for health care and voluntary sector professionals The Dispersal Process for Asylum Seekers Living with HIV.

Drawing on our work in this field we responded in 2007 to a UK Border Agency review of policy and practice of the dispersal process for asylum seekers with healthcare needs. Read the response, Review of Border and Immigration Agency Policy Bulletin on Dispersing Asylum seekers with Healthcare Needs Including Pregnancy.

If you are a healthcare or voluntary sector professional involved in the dispersal process for asylum seekers then visit our section on meeting the needs of asylum seekers living with HIV.

Detention and Removal

In 2006 we undertook a survey of healthcare managers in the UK’s 11 Immigration Removal Centres (IRCs) about the management of HIV in these facilities. Read the results of the survey Immigration Removal Centre Responses to HIV and AIDS: Results of a survey of healthcare managers. In line with the recommendations, NAT have worked with the British HIV Association and IRC healthcare managers to develop a resource that provides best practice guidance to support high-quality care for detainees living with HIV in IRCs. Read the booklet Detention, Removal and People Living with HIV.

NHS Charging

NAT thinks that HIV treatment and care should be exempt from NHS charges regardless of residency status.  It is clear that these regulations actually prevent vulnerable people, including pregnant women, from accessing the vital treatment they need because they cannot afford the charges. Often destitute, those unable to pay such bills have had their treatment delayed, denied, interrupted or withdrawn. Many have been pursued aggressively by debt collectors. Others who are in fact entitled to free treatment have had it mistakenly denied by NHS officials and clinicians confused over the regulations.
 
NAT has responded to the February-June 2010 Department of Health Review of Access to the NHS for Foreign Nationals.  The Review suggests changes to the charging Regulations, including that refused asylum seekers on Section 4 or Section 95 support should not be charged for NHS hospital treatment - NAT strongly welcomes this proposal.  However, there are remaining concerns,  which you can read about in NAT's submission to Department of Health Review of Access to the NHS by Foreign Nationals (charging Regulations) - June 2010.

To share your thoughts and experiences on migration policy please contact policyandcampaigns@nat.org.uk