Mind the Gap : Rapport du sommet sur la migration et le VIH

30th mars 2023

We brought together supporters and stakeholders from 21 European countries on 2 – 3 November 2022 for our first annual Mind the Gap: Migration and HIV Summit. Though we know that migrant communities are innovative, resilient and effective at creating impact in their localities, oftentimes with limited resources and institutional support, our summit was an acknowledgement that we can make greater progress by leveraging our collective expertise, experience and perspectives to address the common challenges that migrant communities face across Europe when trying to access healthcare.

The summit spanned two days:

• 59 participants highlighted the expertise and innovation from the community on day one
• 73 participants focused on a high-level policy roundtable on day two

Conversations and sessions among migrant-led organisations; those living with HIV; academics; representations from UNAIDS, WHO, the European Commission and IAPAC; funders; representatives from pharmaceuticals; and other supporters ultimately pointed towards the lack of immigration status as the key barrier preventing migrants from accessing healthcare in Europe. This exclusion is underpinned by:

• restrictive conditions along migration journeys that exacerbate health inequities and expose migrants to increased health risks
• legal, social, cultural, practical and economic barriers to HIV prevention and care services
• anti-migrant movements across the EU/EEA
• punitive policies that limit support for migrants in precarious circumstances
• xenophobic, homophobic, transphobic, anti-sex worker and racist vitriol, stigma and discrimination
• the fallouts from COVID-19 and the war in Ukraine that compound healthcare disparities, systems inadequacies and social and economic inequalities impacting Black and ethnic minority migrant communities

The gaps

Our full report details the barriers and gaps identified by stakeholders that impede the realisation of universal healthcare for migrants and they are broadly summarised as:

• the prevention and testing gap
• the access gap
• the data gap
• the stigma gap
• the policy gap

You can watch recordings of the summit ici. and download the full report below to see explanations of these gaps and stakeholder recommendations for improving migrant health outcomes. Our Mi-Health Europe team is leading a working group to draft a position paper based on summit outcomes and we continue to gather data with our Mi-Health HIV Partnership to better advocate for migrant-responsive and inclusive healthcare policies. We look forward to bringing supporters and stakeholders together again later in 2023 to further narrow these gaps and more fully include migrants living with or at risk for HIV in healthcare in Europe.

A final note

Without the diverse perspectives and expertise of all participants and stakeholders, the first of its kind Mind the Gap summit would not have offered the engaging and action-oriented experience that it was. We wish to warmly thank all for their participation, enthusiasm and feedback. Their knowledge and experiences were instrumental in discussions, group work and in shaping the direction of our future work. We would also like to especially thank our capable steering committee members and summit collaborators for their expertise, support and time. As always, we remain grateful for our Mi-Health HIV Partnership members as well as for the continued support of our sponsors.

Recordings of summit ici.

Are you PrEPared for the Year?

16th janvier 2023

By: Lissilanne Silva (@lissilanne)

The year just started. New resolutions are being drawn. Do yours include keeping your sexual health in check? Are you PrEParing yourself for the months ahead?

If you’re not familiar with PrEP – Pre-exposure prophylaxis (PrEP) is a medication that can help prevent HIV transmission. It is taken daily by individuals who are at high risk of contracting HIV, such as people who have multiple sexual partners or who are in a sexual relationship with an partner who has a detectable viral load or unknown HIV status. This is one of the greatest advances to prevent transmission of HIV, since for many years such type of preventive medicine wasn’t available.

PrEP is highly effective at reducing the risk of HIV transmission and has been shown to be an important tool in the fight against HIV. However, despite its effectiveness, PrEP use remains low in certain communities, particularly among migrant populations in Europe. Migrants may face barriers to accessing PrEP due to language barriers, lack of insurance and lack of knowledge about the medication.

There are some steps that might increase the uptake of PrEP, such as providing education and awareness about PrEP and its effectiveness in preventing HIV transmission. This can be done through community-based organizations or through partnerships with migrant-led organizations. It is also important to ensure that information about PrEP is provided in a language that is accessible to migrants and that cultural sensitivity is taken into consideration.

Another action might be addressing the accessibility of the medicine for migrant populations. This can include providing PrEP at reduced or no cost, as well as ensuring that there are enough healthcare providers who are trained to prescribe and monitor PrEP use. It is also important to address any legal barriers that may prevent migrants from accessing PrEP, such as immigration status or, in the case of some countries, lack of insurance.

Additionally, providing education and resources for safer sex practices, such as using condoms, remains critical to reduce the risk of HIV and other STIs. This might include providing free condoms and promoting their use, as well as providing education about the importance of regular testing for HIV and other STIs.

On the other hand, stigma surrounding HIV and PrEP sadly remains prevalent. Reducing (or eliminating) this factor also includes sharing the realities of people living with HIV and the effectiveness of ART in managing the virus.

But now the year is 2023 and we can write a better page of our story, right?  Shall we then include zero tolerance for any sort of discrimination and promote PrEP use among all key populations, including wide access to sexual health services for migrant communities in Europe?

Mi-Health Europe is surveying the levels of PrEP awareness and uptake among migrants in Europe, as this is an important step in reducing HIV transmission and improving the overall health of our communities. We believe that access through education, resources and addressing barriers to access, it is possible to increase PrEP use and reduce the burden of HIV among migrant populations. That´s is one of our wishes for 2023!

Visit us ici. and find out where you can access PrEP and other treatment support in your country.

Watch this space for updates on our Mi-Health HIV Partnership. Would your organization be interested in partnering with us?We would love to hear from you. Feel free to reach out at mihealth@africadvocacy.org.

World AIDS Day 2022: what if the result is positive?

6th décembre 2022

By: Lissilanne Silva (@lissilanne)

Close to 2 million people became infected with HIV in 2021, adding up to the global estimation of the 38 million people currently living with the virus.

As World AIDS Day is celebrated this month, now is the time for reflection and urgent action. Today, as we write this piece of message, we wish to draw attention and raise awareness to action we all should take regardless any HIV result.

 We need to educate ourselves

Regardless of all medical breakthroughs, there are still many myths and misconception about HIV. The impact of this is highly detrimental as it not only keeps people from seeking appropriate HIV care but also from disclosing the status out of fear. Stigma kills. Stigma prevents people from coming forward and seeking help.

Our status, our health: test always

Access to HIV treatment is free in the United Kingdom regardless your immigration status (and you can find information on other EU/EEA countries ici.). Antiretroviral therapy or ART is available for those that know their status. This is the only way to keep a healthier life for years. It´s been proven that early access to treatment offers greater benefits as treatment helps reducing viral load (which is the amount HIV in the blood), reduces the appearance of other HIV-related illness and prevents transmission to others. HIV preventing medicine is available called pre-exposure prophylaxis (PrEP) and is highly effective.

Demystification

1. HIV diagnosis is not a death sentence (anymore)
2. U = U
3. HIV ≠ AIDS
4. You can live healthier with a positive HIV diagnosis
5. Appropriate HIV care is available
6. Safe sex always regardless of the status
7. Stand for zero discrimination and stigma
8. You can get pregnant and have kids (if you wish)
9. You’re entitled to privacy (regardless)

At Mi Health Europe, we work with diverse communities to ensure that information is accessible and embraced. We share out available services and respect your privacy.

Watch this space for updates on our Mi-Health HIV Partnership. Would your organization be interested in partnering with us?

We would love to hear from you. Feel free to reach out at mihealth@africadvocacy.org.

Announcing our Mind the Gap: Migrant HIV Summit!

15th septembre 2022

Organised by Africa Advocacy Foundation and its Partenariat Mi-Health VIH, the first annual Mind the Gap: Migrant HIV Summit will take place 2 – 3 November 2022 in Brussels, Belgium.

Mi-Health Europe’s vision is a European region in which all migrants are able to realise a healthy and safe life. We believe that by elevating and resourcing the expertise and experience of frontline advocates, migrants and those with intersectional identities, we can collaborate to achieve innovative, data-driven solutions to migrant health inequalities; share resources, best practice and knowledge across the region; and influence national and regional policy so that it is more responsive to the healthcare needs of migrants living with and at risk for HIV.

Migrants living in the EU/EEA face specific vulnerabilities to HIV and must navigate unique legal, social, cultural, linguistic and economic barriers to access prevention and care services. The rise of anti-migrant movements across the region has also ushered in a new wave of punitive policies, limited support for migrants in vulnerable situations, and xenophobic, homophobic, transphobic and racist vitriol. Furthermore, the fallout from COVID-19 and the war in Ukraine continues to compound these healthcare disparities, systems inadequacies and social and economic inequalities impacting Black and ethnic minorities.

Though limited, the available data illustrates these deprivations.

• Despite accounting for only 12% of the EU population, migrants represented 44% of new HIV diagnoses in 2019⁽¹⁾
• 35% of migrants acquire HIV after arriving in Europe⁽²⁾
• 20 EU/EEA countries report major gaps in HIV prevention services for undocumented migrants⁽³⁾

Africa Advocacy Foundation and its Mi-Health Europe programme, representing our partner organisations in 10 high prevalence European countries, are organising the Mind the Gap summit to explore a more comprehensive approach to addressing the health needs of migrants across the EU.

We are inviting a range of stakeholders including partners from our Partenariat Mi-Health VIH, migrant-led organisations, academic researchers, policymakers and commissioners under the theme of “Mind the Gap.” Together, we will address:

• key challenges and gaps in the HIV cascade of care, including lived experiences from the frontline
• data and research gaps in HIV, including launching a petition for better data for migrants
• prevention, testing and treatment guidelines for migrants, including access to innovative biomedical interventions such as PrEP and U=U
• advocating for a broader approach to inclusion and health equity regardless of ethnicity or origin
• practical ways of addressing the immediate HIV-related needs of migrants from conflict areas, such as Ukraine and the Sahel region

Structure

• Day 1 will focus on community stakeholders presenting experiences from the frontline and brainstorming on key messaging and discussion points for Day 2
• Day 2 will feature a roundtable discussion with policymakers and key institutions on actionable recommendations and steps to influence HIV and healthcare policies and practices with the goal of advancing the migrant health agenda across Europe.

Watch this space for additional information on the summit. For any questions or to get involved, contact Denis Onyango, Programmes Director, at denis@africadvocacy.org.

⁽¹⁾ https://www.aidsmap.com/news/aug-2021/over-third-hiv-cases-among-migrants-europe-were-acquired-after-migration

⁽²⁾ https://www.aidsmap.com/news/aug-2021/over-third-hiv-cases-among-migrants-europe-were-acquired-after-migration

⁽³⁾ European Centre for Disease Prevention and Control. HIV and migrants. Monitoring implementation of the Dublin Declaration on Partnership to Fight HIV/AIDS in Europe and Central Asia: 2017 progress report Stockholm: ECDC; 2017.

“Monkeypox is not a gay disease!”

15th septembre 2022

By: Lissilanne Silva (@lissilanne)

Oscar Bolaños Melian has been volunteering for the past 3 years at Noaks Ark Mosaik, one of the Mi-Health HIV Partnership partner organisations in Sweden, where he migrated to nearly 5 years ago. Oscar is part of the Partnership Steering Committee, an HIV advocate and an art lover. He has also candidly shared with us his life experiences, including the discrimination that sadly he continues to face as a gay man.

Oscar, 56 years old, was born in Spain in the small Grand Canary Island. He remembers a happy childhood — full of energy and a huge love for dance that later was part of artistic life as a drag queen. He also remembers the key events that marked his life to this day and the lessons he learned from them.

From a very young age, learning languages played a big role in his life as he describes that speaking different languages “gives him freedom”, a freedom that he felt was threatened when he contracted HIV nearly 20 years ago. For him, this was a life changing moment that dictated the steps he would take moving forward. It led to him raising awareness about the virus, especially within the gay community, and its relationship with drugs.

Though Oscar is open about his status today, he recalls a period where he had to hide his status due to the homophobia he would face in previous workplaces. Recently, with the outbreak of monkeypox, Oscar saw himself and his community, once again, being associated and discriminated against in relation to a virus.

“Monkeypox is not a gay disease!”, says Oscar after having contracted it and endured discriminatory remarks that the virus is now carrying. To him, a different sexual orientation is not the reason to get a disease or virus and campaigning to zero stigma can save us all from the nightmare people suffered, rooted in a deep lasting stigma that remains to this date with the outbreak of HIV/AIDS back in the 80s. These medical conditions spread together within a social context of fear, shame and prejudice.

Oscar shared that the use of drugs and engaging in unprotected sex with multiple partners is part of the reality of some young men in his hometown that are sadly unaware of the possible risks of such a lifestyle. Hence, for him, raising awareness and providing access to information about HIV and other sexually transmitted infections is fundamental if we want to eradicate the epidemic by 2030.

Specialists confirm that giving access to relevant and key foundational information about sexual health, reduces the risks of infection. It also reduces stigma, a factor that not only prevents those that that are HIV positive from being open about their status, but also to prevents them from seeking support and remaining on effective treatment after the positive diagnosis. There have been transformational changes in HIV treatment and prevention since the 80s and it should no longer be a death sentence.

Oscar, a travel, and language lover (he currently speaks 6 main languages!), shares that despite obstacles that he might be facing, he remains a man full of dreams with a desire to move forward. Going back to his home island in Grand Canary and settling there with a gastronomy and arts business is part of his forward vision. In the meantime, he´s happy with his advocacy work and his married life to (partner name), a painter and an art lover just like him. 

The Mi-Health Europe team would like to thank Oscar for his candor and willingness to share his experiences. Watch this space for updates on our Mi-Health HIV Partnership. Would your organization be interested in partnering with us? We would love to hear from you. Feel free to reach out at mihealth@africadvocacy.org.

Mi-Health Europe on Partnering only for the good!

16th août 2022

By: Lissilanne Silva (@lissilanne)

What do you think when you hear of the word “partnering”? Perhaps, you might think of it in a business setting or something more personal, more intimate such as getting into a relationship, but what about the partnering for good?

Every year, close to 2 million individuals cross into Europe, all seeking better life conditions ranging from political to socio-economic, wellbeing to health. For these people, access to (better) health can become quite challenging when the receiving country does not provide the best policies or environment for them. This is the reason why the collaborations between non-governmental organizations (NGOs), private sector funds and civil society are crucial to sooth some of the stress that migrant communities face in these precarious situations. This is also why we keep pushing for better health policies for all. And this is why we at Mi-Health Europe created the Mi-Health HIV Partnership.

Under the leadership of Africa Advocacy Foundation, we were awarded funding from Gilead’s Zeroing In- Ending the HIV Epidemic grant, as our primary work and program entails ending the HIV epidemic in vulnerable migrant communities across Europe:

• We are developing culturally appropriate HIV educational materials;
• We are conducting innovative HIV testing initiatives to address the gaps in the HIV cascade of care for vulnerable migrants;
• We are creating opportunities to share best practice and expertise among the frontline organizations in our partnership.

Although we at Mi-Health Europe are the lead organization, this program requires collaborative implementation, pushing, therefore, towards partnerships for good. Our implementing partners for Zeroing In are spread across Europe. We´re all together 10 migrant-led organizations that mutually agreed for the first time ever to work in a partnership to advance HIV knowledge, testing and treatment and to address other obstacles to healthcare access that disproportionately impact migrant communities in Europe.

Zeroing In was established by Gilead to empower communities highly affected by HIV and COVID-19 on their current and future wellness and health activities. It is also quite unique as it encapsulates innovative approaches using digital health innovations as well as continuous and close contact with the communities most impacted by HIV. The main areas of this program are Comprehensive HIV Innovation Programs, Digital Health Innovations and – where our Mi-Health HIV Partnership sits – Community Outreach and Education.

For us, the organizations helping to implement our Mi-Health HIV Partnership are the backbone for this challenging but doable mission of ending the HIV epidemic amongst migrant communities in Europe. Improving migrant health is only possible if forces are joined for more partnerships with similar goals. We formed this partnership because we realized that individually, each of our organizations can only achieve so much, but together we can advance community-driven solutions to address the worsening precarity of migrants across the region and to improve migrant health outcomes. We are looking forward to continuing to advance our partnerships for good as we grow

So, this is a bit of the latest on our partnership for good and we are very happy to be doing this work with Plateforme Prevention SIDA (Belgium), AIDS Solidarity Movement (Cyprus), Association PASTT (France), Afrikaherz (Germany), Open Paths Athènes (Greece), Associazione LHIVE (Italy), Stichting AFAA Netherlands (Netherlands), Noaks Ark Mosaik (Sweden) & FPCCSIDA (Portugal).

Watch this space for updates on our work and Partnership. In the meantime, what for the good have you done lately? Would your organization be interested in partnering with us? We would love to hear from you. Feel free to reach out at mihealth@africadvocacy.org or anne@africadvovacy.org.

More on Gilead’s Zeroing In: Ending the HIV Epidemic grant program, please check ici..