"Left behind": why implementing migration-aware responses to HIV for migrant farm workers is a priority for South Africa. 2020

Thea de Gruchy, and Jo Vearey
The African Centre for Migration & Society, University of the Witwatersrand, Johannesburg, South Africa.

Like many other countries, South Africa (SA) has committed to the Sustainable Development Goals that aim to "leave no-one behind", in efforts towards universal health coverage, and meeting the UNAIDS 90-90-90 targets through the implementation of universal test and treat (UTT) interventions. SA is associated with high levels of international and internal migration that, in certain contexts, are known to (1) increase the risk of acquiring HIV and (2) present challenges to HIV treatment access and continuity. Despite this, migration and mobility are not adequately considered in responses to HIV. As SA rolls out UTT programmes and antiretroviral treatment as prevention (TasP) interventions, including pre-exposure prophylaxis (PreP), there is an urgent need to ensure that these are migration-aware and mobility-competent. In SA, a key population that experiences a disproportionate HIV burden is international migrant farm workers living and working on commercial farms along the border with Zimbabwe. In this article, a social determinants of health approach is applied to explore the context within which this population struggles to access positive determinants of health, including the public health care system, and the implications of this for HIV programming. It is argued that, unless policies and programming become migration-aware and mobility-competent, UTT and TasP interventions will struggle to address the high burden of HIV among this population and, as a result, progress towards global health targets will be limited.

UI MeSH Term Description Entries
D003695 Delivery of Health Care The concept concerned with all aspects of providing and distributing health services to a patient population. Delivery of Dental Care,Health Care,Health Care Delivery,Health Care Systems,Community-Based Distribution,Contraceptive Distribution,Delivery of Healthcare,Dental Care Delivery,Distribution, Non-Clinical,Distribution, Nonclinical,Distributional Activities,Healthcare,Healthcare Delivery,Healthcare Systems,Non-Clinical Distribution,Nonclinical Distribution,Activities, Distributional,Activity, Distributional,Care, Health,Community Based Distribution,Community-Based Distributions,Contraceptive Distributions,Deliveries, Healthcare,Delivery, Dental Care,Delivery, Health Care,Delivery, Healthcare,Distribution, Community-Based,Distribution, Contraceptive,Distribution, Non Clinical,Distributional Activity,Distributions, Community-Based,Distributions, Contraceptive,Distributions, Non-Clinical,Distributions, Nonclinical,Health Care System,Healthcare Deliveries,Healthcare System,Non Clinical Distribution,Non-Clinical Distributions,Nonclinical Distributions,System, Health Care,System, Healthcare,Systems, Health Care,Systems, Healthcare
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000067565 Farmers Persons who cultivate land or crops, or raise LIVESTOCK. Agricultural Workers,Farm Workers,Farmworkers,Ranchers,Agricultural Worker,Farm Worker,Farmer,Farmworker,Rancher,Worker, Agricultural,Worker, Farm,Workers, Agricultural,Workers, Farm
D000080423 Universal Health Care Access for all people to needed health services (including prevention, promotion, treatment, rehabilitation and palliation) of sufficient quality to be effective while also ensuring that the use of these services does not expose the user to financial hardship. (From https://www.who.int/healthsystems/universal_health_coverage/en/) Universal Healthcare
D013019 South Africa A republic in southern Africa, the southernmost part of Africa. It has three capitals: Pretoria (administrative), Cape Town (legislative), and Bloemfontein (judicial). Officially the Republic of South Africa since 1960, it was called the Union of South Africa 1910-1960. Republic of South Africa,Union of South Africa
D014171 Transients and Migrants People who frequently change their place of residence. Migrants,Migrant Workers,Nomads,Nonmigrants,Squatters,Transients,Migrant,Migrant Worker,Migrants and Transients,Nomad,Nonmigrant,Squatter,Transient,Worker, Migrant,Workers, Migrant
D014943 Global Health A multi- and interdisciplinary field concerned with improving health and achieving equity in health for all people. It transcends national boundaries, promotes cooperation and collaboration within and beyond health science fields, and combines population-based disease prevention with individually-based patient care. International Health Problems,World Health,International Health,Worldwide Health,Health Problem, International,Health Problems, International,Health, Global,Health, International,Health, World,Health, Worldwide,Healths, International,International Health Problem,International Healths,Problem, International Health,Problems, International Health
D015658 HIV Infections Includes the spectrum of human immunodeficiency virus infections that range from asymptomatic seropositivity, thru AIDS-related complex (ARC), to acquired immunodeficiency syndrome (AIDS). HTLV-III Infections,HTLV-III-LAV Infections,T-Lymphotropic Virus Type III Infections, Human,HIV Coinfection,Coinfection, HIV,Coinfections, HIV,HIV Coinfections,HIV Infection,HTLV III Infections,HTLV III LAV Infections,HTLV-III Infection,HTLV-III-LAV Infection,Infection, HIV,Infection, HTLV-III,Infection, HTLV-III-LAV,Infections, HIV,Infections, HTLV-III,Infections, HTLV-III-LAV,T Lymphotropic Virus Type III Infections, Human
D044966 Anti-Retroviral Agents Agents used to treat RETROVIRIDAE INFECTIONS. Antiretroviral Agent,Antiretroviral Agents,Agent, Antiretroviral,Agents, Anti-Retroviral,Agents, Antiretroviral,Anti Retroviral Agents

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