Dispersed HIV positive asylum seekers need care throughout UK
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《英国医生杂志》
EDITOR—I strongly agree with Creighton et al that inappropriate dispersal of asylum seekers with HIV may lead to increased medical and psychosocial problems.1 They also point out that the national asylum support service should seek specialist advice and consider the impact on infrastructure and staffing at the receiving centre. Although the study reported by Creighton et al was conducted in England, similar problems exist in Wales, where the enforced dispersal of non-indigenous people to areas where there was previously little ethnic diversity can further stigmatise an already vulnerable group.
I am a single handed HIV doctor in Swansea and provide daily cover for 170 HIV positive patients, of whom 54 are non-indigenous, mainly asylum seekers, 46 of them women. These women are of particular concern since many have been raped and may be separated from their families, further adding to the emotional and physical trauma of being HIV positive. Most have been dispersed from London, where they had social and cultural support from their families and friends within a comparatively larger ethnic group.
Patients are often given very little notice of their imminent dispersal, such that they cannot obtain adequate supplies of drug treatment. Others have been transferred with such complex medical problems and no medical case notes that lives are put at risk. The additional strain on local service provision also seems overlooked when dispersal is decided.
Enforced dispersal of young heterosexual HIV positive patients may have unknown effects on the long term epidemiology of HIV in areas where there was previously a comparatively low incidence of HIV in the heterosexual population.
Kathir G Yoganathan, consultant physician
Singleton Hospital, Swansea SA2 8QA Kathir.Yoganathan@swansea-tr.wales.nhs.uk
Competing interests: None declared.
References
Creighton S, Sethi G, Edwards SG, Miller R. Dispersal of HIV positive asylum seekers: national survey of UK healthcare providers. BMJ 2004;329: 322.3 (7 August.)
I am a single handed HIV doctor in Swansea and provide daily cover for 170 HIV positive patients, of whom 54 are non-indigenous, mainly asylum seekers, 46 of them women. These women are of particular concern since many have been raped and may be separated from their families, further adding to the emotional and physical trauma of being HIV positive. Most have been dispersed from London, where they had social and cultural support from their families and friends within a comparatively larger ethnic group.
Patients are often given very little notice of their imminent dispersal, such that they cannot obtain adequate supplies of drug treatment. Others have been transferred with such complex medical problems and no medical case notes that lives are put at risk. The additional strain on local service provision also seems overlooked when dispersal is decided.
Enforced dispersal of young heterosexual HIV positive patients may have unknown effects on the long term epidemiology of HIV in areas where there was previously a comparatively low incidence of HIV in the heterosexual population.
Kathir G Yoganathan, consultant physician
Singleton Hospital, Swansea SA2 8QA Kathir.Yoganathan@swansea-tr.wales.nhs.uk
Competing interests: None declared.
References
Creighton S, Sethi G, Edwards SG, Miller R. Dispersal of HIV positive asylum seekers: national survey of UK healthcare providers. BMJ 2004;329: 322.3 (7 August.)