Abstract
BackgroundThere is limited knowledge about human immunodeficiency virus (HIV)-positive migrants and their experiences in the Swedish health care system. It is necessary to increase our knowledge in this field to improve the quality of care and social support for this vulnerable group of patients.ObjectiveThe aim of this study was to describe the experiences of HIV-positive migrants and their encounters with the health care system in Sweden.DesignThis is a Grounded Theory study based on qualitative interviews with 14 HIV-positive migrants living in Sweden, aged 29–55 years.Results‘A hybrid of access and adversity’ was identified as the core category of the study. Three additional categories were ‘appreciation of free access to treatment’, ‘the impact of the Swedish Disease Act on everyday life’, and ‘encountering discrimination in the general health care system’. The main finding indicated that participants experienced frustration and discrimination because they were required to provide sexual partners with information about their HIV status, which is compulsory under the Swedish Disease Act. The study also showed that the bias or fear regarding HIV infection among general health care professionals outside of the infectious diseases clinics limited the access to the general health care system for HIV-positive migrants.ConclusionsThe HIV-positive migrants appreciated the free access to antiviral therapy, but wished to have more time for patient–physician communications. The participants of this study felt discrimination in health care settings outside of the infectious diseases clinics. There is a need to reduce the discrimination in general health care services and to optimize the social support system and social network of this vulnerable group.
Highlights
Migration has global impacts on health, especially affecting the human immunodeficiency virus (HIV) epidemic
There is a need to reduce the discrimination in general health care services and to optimize the social support system and social network of this vulnerable group
This study shows that participants felt that the obligation to disclose their HIV status to prospective sexual partners, which is mandatory under The Swedish Disease Act [10], made their lives more difficult
Summary
Migration has global impacts on health, especially affecting the human immunodeficiency virus (HIV) epidemic. There are a variety of obstacles to HIV care for migrants in Western Europe, including legal frameworks, immigration policies, and migrants’ social circumstances [1]. This indicates that there is a clear need for more individualized support of this vulnerable population. The low rate of HIV testing and an unwillingness to accept medical care among subSaharan migrants in Western Europe were found to be based on the fear of death and disease, as well as on the fear of stigma and discrimination [4]. There is limited knowledge about human immunodeficiency virus (HIV)-positive migrants and their experiences in the Swedish health care system. There is a need to reduce the discrimination in general health care services and to optimize the social support system and social network of this vulnerable group
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