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The Home Office is failing people living with HIV in Immigration Removal Centre


By Tamara Manuel

People held in immigration detention in the UK are entitled to the same level of healthcare and patient rights as those in wider society. Unfortunately, we know this does not always happen in practice.

Last week the High Court ruled the Home Office failed to put in place systems to protect people living with HIV after a man was denied his HIV medication for four days at Harmondsworth immigration removal centre (IRC) in August 2019. The ruling found  the Home Office had breached article 3 of the European Convention on Human Rights which states,  “no one shall be subjected to inhuman or degrading treatment or punishment.”

The judge ruled the events of August 2019 “demonstrate the lack of sufficient system” to care for people living with HIV in immigration detention. He noted that staff at the intake unit where the claimant was initially detained “did not know how to obtain the necessary medication” and the staff at the intake unit at Harmondsworth “failed to appreciate the need to administer it without delay.” Adherence to HIV medication is incredibly important; missed doses compromise the efficacy of therapy and can lead to drug resistance which limits future treatment options.

In March 2019 National AIDS Trust published Immigration detention and HIV: Advice for healthcare and operational staff with BHIVA and with input from NHS England. The guidance brings together Home Office rules and guidance and guidelines on HIV prevention, treatment and care, and wider healthcare standards. It provides the information and advice to enable staff in IRCs to meet their obligations and ensure people living with HIV in immigration detention receive the best possible treatment and care.

Initially, the Home Office claimed this guidance was adopted at Harmondsworth IRC. Six days before the hearing the Home Office stated the guidance had not been implemented at Harmondsworth, nor had it been implemented into Home Office policy. The judge said  the confusion over the “simple question” of whether the guidance had become part of Home Office policy was “unedifying, to say the least.”

The state has a positive duty to put in place a legislative and administrative framework to secure the health and well-being of those in detention so as to avoid harm of a kind that would engage article 3. In this case, the judge ruled that the lack of legislative and administrative framework put the claimant at risk of harm. Until an appropriate framework is implemented, people living with HIV in immigration detention continue to be at risk.

Despite the name, a significant proportion of people held in IRCs are not removed from the UK. Of the 24,512 people released from immigration detention in 2019, 61% were released into the community, an increase on previous years. Since 2015 this figure has consistently been higher than 50%. Although we don’t know how many people held in immigration detention are living with HIV, we do know HIV disproportionately affects migrants in the UK and there are considerable public health benefits associated with ensuring access to appropriate HIV-related care for those who need it.

It is crucial all people living with HIV have consistent access to good quality treatment and care. Home Office sources told The Guardian they were considering how they would improve staff understanding of how to obtain HIV medication and the importance of ensuring it is not missed. High-quality care extends beyond ensuring people living with HIV can adhere to their treatment. Good quality healthcare must be matched by non-stigmatising attitudes towards the condition, respect for a person living with HIV’s confidentiality, and implementing opt-out testing for HIV for people upon arrival at an IRC.

The Home Office should urgently work to ensure the standards set out in the guidance are met and its staff are provided with the necessary information and training to implement the guidance to meet the health needs of all people living with HIV in immigration detention.

Tamara Manuel is Policy & Campaigns Officer at National AIDS Trust. You can follow her on Twitter here: @tamaramanuel96

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