14th Annual Conference of the British HIV Association 23-25 April 2008, Belfast

HIV CARE OF DETAINED ASYLUM SEEKERS IN SCOTLAND

HIV Med 2008 Apr 23-25 (Suppl 1);14:13 (abstract no. P15)

C Duncan, WTA Todd, S Dundas and N Kennedy
Area Infectious Diseases Unit, Monklands Hospital, Airdrie, Scotland, UK

INTRODUCTION: Since 2000 our unit has been responsible for the ongoing HIV care of failed asylum seekers detained in a local immigration removal centre. We aimed to review our experience of providing HIV care to detained asylum seekers and to identify challenges faced by HIV care providers.

METHODS: Case note review of all detained patients referred for HIV care from a local immigration removal centre 2000-2007.

RESULTS:Seventeen patients (11 male, 6 female) have been referred. 88% originated in Sub-Saharan Africa. 53% of patients had only one visit to our clinic, 2 were removed prior to review. 94% had previously been reviewed in an HIV clinic in the UK. 53% were on HAART. CD4 count at diagnosis was available in the case-notes for only 53% (mean 270.6 cells/mL, range 130-485). 65% had no information on baseline resistance testing. Full treatment history was available for 83%, full baseline serology for only 35%. 39% had mental health problems. Of these, one patient experienced post-traumatic stress disorder and one had significant malnutrition from a previous self-imposed hunger strike. One patient (CD4 count 154) was removed prior to commencing PCP prophylaxis and HAART. Another patient on HAART experienced treatment failure with a low CD4 count and detectable viral load, but was removed without PCP prophylaxis. New diabetes and positive syphilis serology were other unresolved issues identified prior to removal. Final destination was deported (7), transferred (4), released (1), or unknown (4). One patient continues to be detained.

DISCUSSION: We identified several cases where deportation or transfer to another removal centre was likely to result in adverse impacts on the HIV management, physical or mental health of detainees. We identified some limitations in the basic information available to clinicians.

2008-04-23
P15

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