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EDITOR – Fassil raises the issue of tuberculosis control in asylum
seekers in the UK1. We believe that HIV infection in this group has
important implications both for public health and for their asylum
claims.
In Liverpool, many asylum seekers from countries with a high HIV
prevalence have been housed in red light areas of the city.
Language barriers and cultural taboos make messages about safe sex
difficult to convey, putting new arrivals and locals alike at increased
risk of HIV infection.
Home Office guidelines concerning asylum seekers with AIDS/HIV state that
“there may be cases where it is apparent that there are no facilities for
treatment available in the applicant’s own country. Where evidence
suggests that this absence of treatment would significantly shorten the
life expectancy of the applicant it will normally be appropriate to grant
leave to remain”2. In a test case in the European Court of Human Rights,
Britain was held guilty of “inhuman treatment” in trying to deport a
patient with AIDS to St Kitts (where anti-retroviral treatment was
unavailable)3. As HIV treatments in the UK improve, so the “inhumanity”
of repatriating patients
with HIV/AIDS to such countries will increase.
For both these reasons, influx of HIV positive asylum seekers is likely to
affect the work of clinicians and public health doctors in years to come.
We therefore welcome Fassil’s proposal of a comprehensive health
assessment for asylum seekers, and suggest that this should include
education about HIV.
Adrian Martineau, senior house officer
Fred Nye, consultant physician
Regional Infectious Disease Unit, University Hospital Aintree, Lower
Lane, Liverpool L9 7AL
Qutub Syed, regional epidemiologist
John Moores University, IM Marsh Campus, Barkhill Road, Liverpool L17
1. Fassil, Y. Looking after the health of refugees. BMJ 2000;
321:59 (1 July)
2. Immigration and Nationality Department of the Home Office B
Division Instructions, August 1995 BDI 3/95.
Education about HIV should be included in health assessment
EDITOR – Fassil raises the issue of tuberculosis control in asylum
seekers in the UK1. We believe that HIV infection in this group has
important implications both for public health and for their asylum
claims.
In Liverpool, many asylum seekers from countries with a high HIV
prevalence have been housed in red light areas of the city.
Language barriers and cultural taboos make messages about safe sex
difficult to convey, putting new arrivals and locals alike at increased
risk of HIV infection.
Home Office guidelines concerning asylum seekers with AIDS/HIV state that
“there may be cases where it is apparent that there are no facilities for
treatment available in the applicant’s own country. Where evidence
suggests that this absence of treatment would significantly shorten the
life expectancy of the applicant it will normally be appropriate to grant
leave to remain”2. In a test case in the European Court of Human Rights,
Britain was held guilty of “inhuman treatment” in trying to deport a
patient with AIDS to St Kitts (where anti-retroviral treatment was
unavailable)3. As HIV treatments in the UK improve, so the “inhumanity”
of repatriating patients
with HIV/AIDS to such countries will increase.
For both these reasons, influx of HIV positive asylum seekers is likely to
affect the work of clinicians and public health doctors in years to come.
We therefore welcome Fassil’s proposal of a comprehensive health
assessment for asylum seekers, and suggest that this should include
education about HIV.
Adrian Martineau, senior house officer
Fred Nye, consultant physician
Regional Infectious Disease Unit, University Hospital Aintree, Lower
Lane, Liverpool L9 7AL
Qutub Syed, regional epidemiologist
John Moores University, IM Marsh Campus, Barkhill Road, Liverpool L17
1. Fassil, Y. Looking after the health of refugees. BMJ 2000;
321:59 (1 July)
2. Immigration and Nationality Department of the Home Office B
Division Instructions, August 1995 BDI 3/95.
3. D v UK (1997) 24 EHRR 423
Competing interests: No competing interests