Migrant populations are fluid, difficult to identify, and are often left out of national HIV/AIDS prevention programming. What can development programs do to prevent an increase in HIV transmission among these groups?
For nearly four decades, HIV has not only been a public health emergency, but also one of the biggest barriers to global development. This disease costs national governments billions of dollars each year in treatment and prevention costs as well as opportunity costs in relation to immune-compromised citizens who are no longer able to contribute to the gross domestic product. Some studies have estimated that for every 10 percent HIV prevalence in a given country, gross national product (GNP) growth could decrease by more than one percent.
Luckily, in recent years, there has been a general reduction in HIV infection rates, thanks in large part to UNAID’s 90-90-90 goal. This goal seeks to ensure, by the year 2020, that 90 percent of all people living with HIV know their status, 90 percent of those people receive treatment with antiretroviral therapy (ART), and 90 percent of those individuals have viral suppression. The path to achieving this goal has not only improved the health of HIV+ individuals but also reduced infection rates. The increase in the number of people on ART and with a suppressed viral load has contributed to lower transmission rates, as viral suppression reduces transmission rates.
65.3 Million People Left Behind
Globally, the tides are turning in the fight against HIV/AIDS, yet there are subsets of the world where the virus is still taking a huge toll. Perhaps no marginalized group has been in the spotlight more in recent years than internally displaced persons (IDP) and migrant communities. There have been no large-scale studies conducted on HIV prevalence rates in IDP and migrant communities. Case-by-case studies indicate that these rates are always context-specific. In fact, some studies note that HIV rates among migrant communities are often lower than host communities. Nevertheless, the extremely fragile state of these communities notes a need for a focused and targeted HIV prevention model. Last month, the International Organization for Migration (IOM) published an article which found that while there is no correlation between migrant communities and HIV rates yet, there is a correlation between these communities and higher vulnerabilities to HIV, increasing the threat in the future.
Although current trends in HIV awareness and treatment are improving, migrant and IDP communities continue to be excluded. In 2010, one study found that 57 percent of countries with Global Fund co-sponsored national strategic plans to combat HIV omitted IDPs from the plan, and another 48 percent omitted migrants and refugees. Only 21 percent of countries included explicitly referenced activities targeting refugees and IDPs. With 65.3 million people forcibly displaced in 2015, a significant amount of people are being left out of HIV programming. These same communities are subject to other detrimental factors which can increase HIV transmission, including sexual assault, forced prostitution in return for food and other goods, and increased domestic violence and abuse; these factors impact young women the most.