African Migration and Aids in Europe: the changes of paradigms

Dr Elhadji MBAYEScience po Grenoble/ IRD/ U.

Montrealelhadjimbaye@gmail.com

Introduction1. Aids and migration in Europe is an issue between

rich and poor countries.

2. Heterogenenous contribution of migrants in European countries HIV epidemic.

3. Aids among migrants in Europe do not concern only those coming from SSA.

Focus on Aids among Black migrants coming from SSA in Europe.

Aids among SSA in Europe1. Heterosexual infections2. Feminisation3. Late HIV/Aids Diagnosis4. Socioeconomic issues 5. Cutural competences

Feminisation of Aids among SSA migrantsFrom 1999 to 2006, 41% of new cases HIV reported

infected through MTC in Europe were from SSA.

Their vulnerability is both social and biological bases.

Affected by gender inequalities, stigmatisation, isolation…

Substantial challenges are needed to improve their living conditions as migrants, women, black, LHIV: four vulnerabilities!

Who are migrants LHIV en Europe? Undocumented migrants : « illegal migrants », « Sans papiers » : those

without any legal residence in the country in which they are living

Legal migrants : those who have a permit card to stay and move in Europe

Foreigners : those who have an other nationality

Asylum seekers, refugees : protected by the Geneva convention

Immigrants: born foreigner in an other country

« Ethnic minorities », migrants : grouping those who have a migrant background (natives whose parents are migrants, immigrants…)

Vulnerability to HIV/Aids and access to health care and to a resident permit depend whether MLIH are in one of these categories.

Changes of political and research paradigms

A risky approach A public health approach

A contain and control Strategy A cooperation and inclusion approach

A SES approach Racial and Ethnic minorties approach

Access to healthcare for UM (PICUM, MDM)

1/3 of UM in Europe are unaware of their rights to healthcare.

70% of theoretical beneficiaries do not have access to healthcare.

The main actions must be to encourage EU states to respect the International and European conventions guarantying access to heathcare for all human beings condemning xenophobia and racism.

Theoretical and effective access to health (MDM)

6,9

90,1

99

70,4

99,3

78,3

0

7,2

13,9

38,2

55,2

24

0

25

50

75

100

Greece France Belgium Spain Italy Alltogether

Theoretical access Effective access

Proportion of out of status people with theoretical and effective access to free

healthcare

15,6

15,2

13,4

13,2

11,7

11,1

7,2

3,9

3,3

2,4

2,1

0,5

0,3

0,1

0,0 5,0 10,0 15,0 20,0

Unawareness of one's rights

Doesn't know where to go

Treatments too expensive

Administrative difficulties

Fear of being denounced

Language barrier

Fear of discrimination

Cultural barrier

Care refused by health professionals

Unsuitable times

Consultation too expensive

No health cover or social security

Housing problem

No trust in doctors

%

%

Obstacles in accessing care

UM and HIV : unawareness of health services available (MDM, 2006)

Frequency of unawarenessof free HIV screening

% CI95% Greece 83.7 74.2-90.8 UK 66.7 29.9-92.5 Portugal 64.7 38.3-85.8 Italy 63.0 54.2-71.1 Belgium 50.3 42.8-57.8 Spain 47.2 40.1-54.4 France 41.0 32.9-49.5 As a whole 54.2 50.6-57.8

Frequency of unawareness of free HIV treatments

% CI95% UK * Greece 100.0 93.4-100.0 Portugal 73.3 44.9-92.2 Italy 68.2 58.5-76.9 France 67.9 59.3-75.7 Belgium 59.8 52.1-67.1 Spain 49.2 42.1-56.4 As a whole 63.1 50.6-57.8

* there is no free treatment in the UK

Criminalisation of HIV Transmission by SSA migrants

Prosecutions of migrants from Sub-Saharan Africa in a lot of European countries.

The helpful role of the media.

Its consequences in violating human rights : lack of effective care, imprisonment, internment in detention centres, deportations…

Deportation of African migrants living with HIV/Aids

In Europe, migrants LAIDS can be protected against deportation by article 3 of ECHR.

BUT because of restrictive interpretations of this article… a lot of deportationsIn UKIn France and others countries…

Result : People are convicted to death when they are deported in countries without accessible treatment!

Human rights instead of humanitarian

Not a Humanitarian political approach

But : 1. Human rights.

2. Public health approach.

3. Fighting against health inequalities

Positive aspectsThe decrease of infections among migrants…The increase of Aids programmes targeting

migrantsThe mobilization of CBOsThe mobilsation of NGOsThe mobilisation of European research and

political networks

Conclusion Curry on fighting against misconceptions

Stop linking immigration control policies with fighting against aids programmes

Curry on reinforcing social mobilization against Aids involving migrants as stakeholders