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Li K, Thaweesee N, Kimmel A, Dorward E, Dam A. Barriers and facilitators to utilizing HIV prevention and treatment services among migrant youth globally: A scoping review. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002851. [PMID: 38354206 PMCID: PMC10866458 DOI: 10.1371/journal.pgph.0002851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 01/04/2024] [Indexed: 02/16/2024]
Abstract
Both migrants and young people experience disproportionately high rates of HIV acquisition and poor access to HIV prevention and treatment services. To develop effective interventions and reach epidemic control, it is necessary to understand the barriers and facilitators to accessing HIV services among migrant youth. We conducted a scoping review to identify these factors for migrant youth ages 15-24, globally. We conducted a PRISMA-concordant scoping review using keyword searches in PUBMED and Web of Science for peer-reviewed primary literature published between January 2012 and October 2022. We included studies that investigated barriers and facilitators to accessing services for migrant youth participants. We used the Socio-Ecological Model as an analytical framework. The 20 studies meeting the inclusion criteria spanned 10 countries, of which 80% (n = 16) were low- and middle-income countries. Study methods included were quantitative (40%), qualitative (55%), and mixed methods (5%). Six studies included refugee youth (30%), 6 included migrant worker youth (30%), 3 included immigrant youth (15%), 2 included rural migrant youth (10%), and 1 included immigrants and refugees. The remainder represented unspecified migrant youth populations (10%). At the individual level, education level and fear of infection acted as barriers and facilitators to HIV services. At the relationship level, social support and power in relationships acted as barriers and facilitators to HIV services. At the community level, barriers to HIV services included discrimination and stigma, while community and religious outreach efforts facilitated access to HIV services. At the structural level, barriers to HIV services included stigmatizing social norms, lack of health insurance, and legal barriers. Migrant youth face significant, unique barriers to accessing HIV services. However, facilitators exist that can be leveraged to enable access. Future implementation science research, enabling policies, and adapted programmatic interventions should prioritize migrant youth as a distinctive sub-population to receive targeted HIV services.
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Affiliation(s)
- Kevin Li
- Office of HIV/AIDS, United States Agency for International Development, Washington, District of Columbia, United States of America
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- STAR, Public Health Institute, Washington, District of Columbia, United States of America
| | - Natasha Thaweesee
- Office of HIV/AIDS, United States Agency for International Development, Washington, District of Columbia, United States of America
- Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, United States of America
- GHTASC, Credence LLC, Washington, District of Columbia, United States of America
| | - Allison Kimmel
- Office of HIV/AIDS, United States Agency for International Development, Washington, District of Columbia, United States of America
- STAR, Public Health Institute, Washington, District of Columbia, United States of America
| | - Emily Dorward
- Office of HIV/AIDS, United States Agency for International Development, Washington, District of Columbia, United States of America
| | - Anita Dam
- Office of HIV/AIDS, United States Agency for International Development, Washington, District of Columbia, United States of America
- GHTASC, Credence LLC, Washington, District of Columbia, United States of America
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Freeman T, Miles L, Ying K, Mat Yasin S, Lai WT. At the limits of "capability": The sexual and reproductive health of women migrant workers in Malaysia. SOCIOLOGY OF HEALTH & ILLNESS 2021:1467-9566.13323. [PMID: 34227694 DOI: 10.1111/1467-9566.13323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 04/07/2021] [Accepted: 06/02/2021] [Indexed: 06/13/2023]
Abstract
Despite the centrality of sexual and reproductive health (SRH) to UN Sustainable Development Goals (SDGs), women migrant workers in Malaysia face an environment inimical to their SRH needs. Drawing on qualitative case study material, we present the first empirical application of the capability approach (CA) to explore the reproductive health needs of women migrant workers in a developing country, offering an original analysis of the capability for SRH of these women. Specifically, we explore the resources available to them; their opportunities and freedoms ("capabilities"); and factors that mediate transformation of resources into capability sets ("conversion factors"). While SRH information and health care are notionally available, women migrant workers face multiple challenges in converting resources into functionings, constraining the achievement of capability for SRH. Challenges include language barriers, personal beliefs, power relations between workers and employers and the consequences of current migration policy. We consider the scale of the challenges facing these women in securing SRH rights, the difficulties of operationalising the CA within such a setting, and the implications of our findings for the adequacy of the CA in supporting marginalised populations.
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Affiliation(s)
- Tim Freeman
- Department of Management, Leadership and Organisation, Middlesex University Business School, Middlesex University, Middlesex, UK
| | - Lilian Miles
- School of Organisations, Economy and Society, Westminster Business School, University of Westminster, London, UK
| | - Kelvin Ying
- School of Health Sciences, Universiti Sains Malaysia (USM), Kota Bharu, Malaysia
| | - Suziana Mat Yasin
- Department of Development Planning and Management, School of Social Sciences, Universiti Sains Malaysia (USM), Penang, Malaysia
| | - Wan Teng Lai
- Centre for Research on Women and Gender (KANITA), Universiti Sains Malaysia (USM), Penang, Malaysia
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Body Dissatisfaction, Weight-Related Behaviours, and Health Behaviours: A Comparison Between Australian and Malaysian in Female Emerging Adults. BEHAVIOUR CHANGE 2021. [DOI: 10.1017/bec.2021.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractThe presence of body dissatisfaction (BD) in non-Western countries is an important area of empirical enquiry. The results reflect collectivistic and individualistic cultures of Malaysians and Australians, respectively, whereby social approval, social acceptance, and cultural values are of high importance to Malaysians compared with the more liberal attitudes of Australians with respect to health behaviours. This study sought to compare: (1) Australian and Malaysian women on BD, thin ideal internalisation, sociocultural influences, problematic weight-related behaviours, and health behaviours; and (2) the degree to which BD is associated with health behaviours (smoking, alcohol consumption, drug use, and sexual behaviours) across the two cultures. Participants were 428 Australian females and 402 Malaysian females aged 18–25 years old. Australians had higher BD, thin ideal internalisation, family and media influences, restrained eating, and poorer health behaviours, while Malaysians had higher peer influence. There was no difference for bulimic behaviours across the two countries. BD was found to have an association with use of drugs, smoking, and sexual behaviours among Malaysian women, but not for Australian participants. The permeation of Western standards of the thin ideal due to increased industrialisation, Westernisation, and modernisation has brought about bulimic behaviours in Malaysian women, similar to that of Australian women.
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Kunpeuk W, Teekasap P, Kosiyaporn H, Julchoo S, Phaiyarom M, Sinam P, Pudpong N, Suphanchaimat R. Understanding the Problem of Access to Public Health Insurance Schemes among Cross-Border Migrants in Thailand through Systems Thinking. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145113. [PMID: 32679855 PMCID: PMC7400460 DOI: 10.3390/ijerph17145113] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/08/2020] [Accepted: 07/09/2020] [Indexed: 01/05/2023]
Abstract
Thailand has become a popular destination for international migrant workers, particularly from Cambodia, Lao PDR, and Myanmar. However, only a fraction of these migrant workers were insured by public health insurance. The objective of this study was to apply systems thinking to explore contextual factors affecting access to public health insurance among cross-border migrants in Thailand. A group model building approach was applied. Participants (n = 20) were encouraged to share ideas about underlying drivers and barriers of migrants' access to health insurance. The causal loop diagram and stock and flow diagram were synthesised to identify the dynamics of access to migrant health insurance. Results showed that nationality verification is an important mechanism to deal with the precarious citizenship status of undocumented migrants. However, some migrants are still left uninsured. The likely explanations are the semi-voluntary nature of the Health Insurance Card Scheme, administrative delay of the enrollment process, and resistance of some employers to hiring migrants. As a result, findings suggest that effective communication is required to raise acceptance towards insurance among migrants and their employers. A participatory public policy process is needed to create a good balance of migrant policies among diverse authorities.
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Affiliation(s)
- Watinee Kunpeuk
- International Health Policy Program, Ministry of Public Health, Tiwanon Road, Nonthaburi 11000, Thailand; (H.K.); (S.J.); (M.P.); (P.S.); (N.P.); (R.S.)
- Correspondence: ; Tel.: +66-2-590-2366; Fax: +66-2-590-2385
| | - Pard Teekasap
- Faculty of Business Administration and Technology, Stamford International University, Motorway Road—Km2, Prawet, Bangkok 10250, Thailand;
| | - Hathairat Kosiyaporn
- International Health Policy Program, Ministry of Public Health, Tiwanon Road, Nonthaburi 11000, Thailand; (H.K.); (S.J.); (M.P.); (P.S.); (N.P.); (R.S.)
| | - Sataporn Julchoo
- International Health Policy Program, Ministry of Public Health, Tiwanon Road, Nonthaburi 11000, Thailand; (H.K.); (S.J.); (M.P.); (P.S.); (N.P.); (R.S.)
| | - Mathudara Phaiyarom
- International Health Policy Program, Ministry of Public Health, Tiwanon Road, Nonthaburi 11000, Thailand; (H.K.); (S.J.); (M.P.); (P.S.); (N.P.); (R.S.)
| | - Pigunkaew Sinam
- International Health Policy Program, Ministry of Public Health, Tiwanon Road, Nonthaburi 11000, Thailand; (H.K.); (S.J.); (M.P.); (P.S.); (N.P.); (R.S.)
| | - Nareerut Pudpong
- International Health Policy Program, Ministry of Public Health, Tiwanon Road, Nonthaburi 11000, Thailand; (H.K.); (S.J.); (M.P.); (P.S.); (N.P.); (R.S.)
| | - Rapeepong Suphanchaimat
- International Health Policy Program, Ministry of Public Health, Tiwanon Road, Nonthaburi 11000, Thailand; (H.K.); (S.J.); (M.P.); (P.S.); (N.P.); (R.S.)
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi 11000, Thailand
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Bierhoff M, Pinyopornpanish K, Pinyopornpanish K, Tongprasert F, Keereevijit A, Rijken M, Chu CS, Nosten F, Perfetto J, van Vugt M, Mcgready R, Angkurawaranon C. Retrospective Review of Documentation Practices of Hepatitis B Immunoglobulin, Birth Dose, and Vaccination at the Hospital of Birth, in Thai Nationals and Migrants in Northern Thailand. Open Forum Infect Dis 2019; 6:ofz518. [PMID: 31890723 PMCID: PMC6934156 DOI: 10.1093/ofid/ofz518] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 12/06/2019] [Indexed: 12/18/2022] Open
Abstract
Background Vaccination remains the mainstay of prevention of hepatitis B virus (HBV) including birth dose and hepatitis B immunoglobulins (HBIGs). National estimates of vaccination coverage exclude migrants. The objective of this study is to investigate documentation practices of HBV-related infant vaccinations in Northern Thailand including migrants. Methods This is a retrospective review of hospital records of women who birthed infants in 2015 at Maharaj Nakorn Hospital, Chiang Mai (CM) or on the Thailand-Myanmar border, Tak. Results Of 2522 women, 987 were from CM (861 Thai nationals, 126 migrants) and 1535 were from Tak (651 Thai residence and 884 Myanmar residence). In CM, documentation for the birth dose vaccine (999 of 999, 100%) and HBIG was complete. In Tak, documentation was 1441 of 1549 (93%) for birth dose and 26 of 34 (76.5%) for HBIG, with missed opportunities including home delivery, delay in obtaining hepatitis B e-antigen status, and limitations of the records. Expanded Program of Immunization (EPI) documentation of 3 follow-up vaccinations dwindled with subsequent doses and distance, and complete documentation of 3 HBV EPI vaccines at the hospital of birth was low, 41.5% (1056 of 2547), but equitable for Thai or migrant status. Conclusions This review provides strong support for excellent documentation of HBIG and birth dose vaccination in urban and rural settings, and in migrants, consistent with Thailand's vaccination policy and practice. Documentation of the 3 HBV EPI at the hospital of birth decreases with sequential doses, especially in families further away. Innovative data linkage is required to prove coverage and identify gaps.
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Affiliation(s)
- M Bierhoff
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Mae Sot, Thailand.,Division of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Kanokwan Pinyopornpanish
- Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - F Tongprasert
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Arunrot Keereevijit
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Mae Sot, Thailand
| | - M Rijken
- Utrecht University Medical Centre and Julius Centre Global Health, Utrecht, The Netherlands
| | - C S Chu
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Mae Sot, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine Research Building, University of Oxford, Oxford, United Kingdom
| | - F Nosten
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Mae Sot, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine Research Building, University of Oxford, Oxford, United Kingdom
| | - J Perfetto
- New York University School of Medicine, New York, New York, USA
| | - M van Vugt
- Division of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - R Mcgready
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Mae Sot, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine Research Building, University of Oxford, Oxford, United Kingdom
| | - C Angkurawaranon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Ayuttacorn A, Tangmunkongvorakul A, Musumari PM, Srithanaviboonchai K, Jirattikorn A, Aurpibul L. Disclosure of HIV status among Shan female migrant workers living with HIV in Northern Thailand: A qualitative study. PLoS One 2019; 14:e0216382. [PMID: 31048890 PMCID: PMC6497284 DOI: 10.1371/journal.pone.0216382] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 04/21/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Disclosure of HIV status is a critical gateway to HIV prevention. Despite many studies on this topic, there is a gap in knowledge regarding HIV status disclosure and risky sexual behavior in HIV-infected female migrant workers. The current study addressed this research gap, and focused on HIV-infected Shan female migrant workers in Northern Thailand. METHODS This study conducted in-depth interviews with 18 HIV-infected Shan female migrants (aged between 23-54 years old) and 29 healthcare workers in district hospitals in Chiang Mai. Content analysis was employed to identify particular themes related to HIV status disclosure, sexual risk behavior, and ART adherence. RESULTS We found that non-disclosure to husbands/partners was mostly related to fear of marital conflict and of losing social and financial support. Non-disclosure prevented Shan female migrant workers from negotiating condom use with their partners. Reasons for not disclosing to friends, family and other community members were mostly related to feared rejection and discrimination due to HIV-related stigma. Accounts of condomless sex in the context of HIV status disclosure suggest that gender norms and male dominance over women influenced decision-making for safe sex. Lastly, some female migrant workers perceived low risk of HIV transmission with good adherence to the ART. CONCLUSIONS This study highlighted the complex challenges of HIV status disclosure among HIV-positive Shan female migrant workers and the link between disclosure/non-disclosure and condom use. There is a pressing need to create realistic disclosure mechanisms that take into account the socio-cultural barriers to disclosure including marital conflicts, stigma, and gender norms. Messages to encourage condom use should be delivered carefully so that knowledge of the HIV transmission reduction qualities of good ART adherence does not serve as a barrier to condom use.
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Affiliation(s)
| | | | - Patou Masika Musumari
- Department of Global Health and Socio-epidemiology, Kyoto University School of Public Health, Kyoto, Japan
- Japan Foundation for AIDS Prevention, Tokyo, Japan
| | - Kriengkrai Srithanaviboonchai
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Linda Aurpibul
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
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