REVIEW Coming and going: Some aspects of care for migrants with HIV in the UK Jane Anderson* Centre for the study of Sexual Health and HIV, Homerton University Hospital NHS Foundation Trust, Homerton Row, London E9 6SR, United Kingdom Accepted 8 May 2008 Available online 9 June 2008 KEYWORDS HIV; Migration; Asylum Summary The impact of more people travelling further, faster and more frequently, particu- larly to and from areas of high HIV seroprevalence, is reflected in the patterns of HIV in Europe and the UK. Diversity of both people and pathogens is increasing. The prevention and treatment of HIV in migrant populations is influenced by a wide range of social, cultural and political factors. Against this complex backcloth, factors such as co existing infections, the variability of HIV, and the particularities of the human host will influence the approach to therapy. ª 2008 The British Infection Society. Published by Elsevier Ltd. All rights reserved. Introduction In an increasingly ‘‘globalised’’ world more people are travelling to more places more frequently and for more reasons than ever before, a pattern that seems set to continue. With them come different world views, different cultures and different experiences of health and health care. In addition, and frequently unknown to the human host, comes a range of geographically related pathogen- passengers. The number of international migrants (people residing in a country other than their country of birth for 12 months or more) has increased over the past 40 years, from about 76 million in 1965 to 188 million in 2005. 1 Legal entry into many European states and access to health and welfare benefits has, in parallel, become more tightly controlled. In the past decade HIV has become an increasingly diverse and complex condition throughout Europe, profoundly influ- enced by the evolution of the global epidemic. Migrants in the UK are a very heterogeneous population comprising people of all races and ethnic backgrounds. However, all are part of the process of transition associated with leaving ‘‘home’’ and negotiating a new culture, circumstances which may make them especially vulnerable to the risk of HIV acquisition. 7 Migrants from countries with a high prev- alence of HIV/AIDS, notably sub-Saharan Africa, bear a dis- proportionate and increasing share of HIV throughout Western Europe and, in most countries including the UK, ac- count for a majority of heterosexually acquired HIV infec- tions. 2,3 History is littered with numerous examples of responsibility for importing and transmitting infections be- ing preferentially attributed to migrant communities. In the * Tel.: þ44 020 8510 5323/7983; fax: þ44 020 89510 7978. E-mail address: jane.anderson@homerton.nhs.uk 0163-4453/$34 ª 2008 The British Infection Society. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.jinf.2008.05.002 www.elsevierhealth.com/journals/jinf Journal of Infection (2008) 57, 11e15