Migrants' access to antiretroviral therapy in Thailand.

OBJECTIVE To investigate migrants' access to antiretroviral therapy (ART) and assess the applicability of ART guidelines to migrants. METHODS Six focus group discussions (FGD) were conducted in Thailand with 74 Burmese migrants: factory workers in Mae Sot and Bangkok, construction site workers in Chiang Mai and unemployed and undocumented HIV-positive migrants in Mae Sot. Thirteen key stakeholders and migrants were interviewed for triangulation. RESULTS (1) Present criteria for in-/exclusion restrict migrants' access to ART. (2) Leading ART guidelines are not applicable for migrants in general. (3) Migrants are likely to experience more problems with adherence to ART than local patients, which increases the importance of ART guidelines. CONCLUSIONS Without ART guidelines that take into consideration the specific circumstances that limit migrants' access to ART, health care providers will continue to render HIV-positive migrants ineligible. Interventions are needed to both make the ART guidelines applicable to migrants and to overcome obstacles restricting migrants' access to ART. This will greatly improve migrants' access to ART and help to save the lives of thousands of HIV-positive migrants.