HIV: CAD study exposes immigrant population's difficulties in accessing health services

There are several factors influencing access to health services for the immigrant population living with HIV in Portugal. The report makes 19 recommendations to mitigate these difficulties.

The vast majority of health access determinants identified in the literature for immigrants in general are common to immigrants with HIV living in Portugal. This is the conclusion of the study "Access to health for immigrants with HIV infection in Portugal", by Ser+ and the HIV Anti-Discrimination Center (CAD VIH).

Factors such as being male, belonging to lower age groups, having a shorter period of immigration in Portugal and being illegally resident are associated with greater difficulty in accessing and using health services in Portugal.

The results of the study identified the greater vulnerability of immigrants with HIV, revealing that more than half of them have experienced various obstacles in accessing and using health services. According to the report, these obstacles are related to "factors inherent to individuals, health professionals and their relationship with users, and structural issues in the NHS".

The report was developed on the basis of focus groups with six health professionals and NGOs, and a questionnaire survey of 407 immigrants living with HIV in Portugal.

Determining factors

According to the report, which can be read in full here, factors such as the level of knowledge about their rights and the functioning of the SNS proved to be decisive for access to and use of these public resources.

The study also highlights that "the complexity and bureaucracy of the system, as well as aspects related to the accessibility and capacity of services, such as waiting times, distance, associated costs and opening hours" are other structural factors that seem to influence access to health services.

Being from Latin America (particularly Brazil), belonging to populations vulnerable to HIV, having lower health and HIV literacy, a higher level of stigma and discrimination associated with the infection are other factors associated with greater difficulties in accessing health services.

Recommendations

The report lists 19 recommendations addressed to the government and competent bodies to mitigate the difficulties faced by immigrant populations with HIV in accessing health services.

Simplifying and standardizing the procedures for immigrants to access the SNS is one of these recommendations. "One of the main obstacles that became apparent in this study is the complexity of the rules and procedures for accessing the SNS, which vary according to the immigrants' origin, length of residence in the country, administrative status and even health status," the document reads. "This measure would promote more equal access to health services as well as easier understanding and application of the legislation," it adds.

The report recommends amending Order 25.360/2001, thus removing the requirement to have been resident in Portugal for 90 days in order to use health services, as well as amending Decree-Law 135/99 to accept self-declaration as proof of residence.

Read the full report here.