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Last Updated: Friday, 6 August, 2004, 00:04 GMT 01:04 UK
Asylum policy sparks HIV concern
Asylum seeker
Many asylum seekers feel isolated
Doctors are concerned that the UK policy of dispersing asylum seekers may lead to increased HIV transmission.

More than 100,000 asylum seekers have been dispersed from London and the South East to alternative locations to try to spread the cost of care.

But doctors responding to a British Medical Journal survey warned that the policy was disruptive and may compromise HIV care.

Many of the aslyum seekers are from regions with HIV/Aids epidemics.

There is no doubt that dispersal disrupts people's treatment, and contributes to ill health.
Lisa Power
Doctors at Camden Primary Care Trust surveyed 56 colleagues working at sexual health clinics.

They were particularly concerned that dispersal was often done at short notice - sometimes just 48 hours - and often without appropriate transfer of medical details.

Only three centres had experienced appropriate transfer of care.

Doctors argue that before the decision to disperse, the National Asylum Support Service (NASS) should take into account expert medical advice.

It should also consider the impact on the infrastructure and staffing of the sexual health clinic that would take over responsibility for care.

Vulnerable patients

Many of the doctors who responded to the survey felt that dispersal of HIV-infected asylum seekers was inappropriate in specific situations.

For instance, it would be wrong to disperse somebody who was just beginning antiretroviral therapy, or undergoing salvage therapy, which is given to patients whose previous drug regimes have failed.

Similarly, many doctors felt it would be wrong to move somebody currently undergoing medical investigations, or whose care involved multiple medical specialities. Neither should dispersal be considered for people with full-blown Aids.

Lisa Power, head of policy at HIV charity the Terrence Higgins Trust, said campaigners had warned NASS that the dispersal policy would be bad, both for the health of individual asylum seekers, and for public health in general before it was implemented.

"There is no doubt that dispersal disrupts people's treatment, and contributes to ill health," she said.

"It is a complete mess. I have heard of people being moved to and from the same town. People are just moved around like chess pieces.

"I have also heard of people who have been dispersed being given money to go back and seek care at their treatment centre of origin."

Ms Power also warned that asylum seekers were sometimes not diagnosed with HIV until they fell ill, as their health was often not their most pressing concern.

Deborah Jack, of the National Aids Trust, said: "Dispersing HIV-positive asylum seekers around the UK removes people from community support and culturally sensitive medical services and ultimately harms their physical health.

"Dispersal, often at short notice, causes distress and disruption of medical treatment which can lead to serious deterioration of their health, increased mother to baby HIV transmission and even death."

Ms Jack called for the dispersal of particularly vulnerable HIV-positive asylum seekers to be stopped immediately, and the policy reviewed.

No evidence

In a statement, the Home Office said there was no evidence that dispersal increased the likelihood of onward transmission of HIV to others.

It said it was working with the Department of Health to improve the dispersal process in order to reduce disruption of health care provision.

The statement said: "In assessing suitability for dispersal NASS take into account relevant information including medical considerations.

"Caseworkers can seek professional medical advice if required.

"NASS disperse asylum seekers with HIV or AIDS to areas where suitable medical treatment is available."

Agencies have long complained that the national disperal programme can disrupt efforts to properly integrate new arrivals into the UK, including ensuring they have suitable medical and practical support.

Warning over immigrant HIV tests
02 Jan 04  |  Health

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