title: Displacement and HIV: Factors Influencing Antiretroviral Therapy Use by Ethnic Shan Migrants in Northern Thailand.
abstract: Migrant populations face increased HIV vulnerabilities, including limited access to antiretroviral therapy. Civil conflict in Myanmar has displaced thousands of people from the minority Shan ethnic group into northern Thailand, where they bear a disproportionate HIV burden. To identify barriers and facilitators of antiretroviral therapy use in this population, we conducted a rapid ethnographic assessment and case study with a clinical sample of Shan migrants receiving treatment for HIV in a district hospital in Chiang Mai, Thailand, Thai nurses providing their care, and health care administrators (n = 23). Barriers included fears of arrest and deportation, communication difficulties, perceived social marginalization, limited HIV knowledge, and lack of finances. Facilitating factors included hospital-based migrant registration services and community outreach efforts involving support group mobilization, referral practices, and radio broadcasts. These findings provided a contextualized account to inform policies, community interventions, and nursing practice to increase treatment access for minority migrant groups.
authors.forename: Jordan K
authors.initials: JK
authors.lastname: Murray
authors.forename: Anthony S
authors.initials: AS
authors.lastname: DiStefano
authors.forename: Joshua S
authors.initials: JS
authors.lastname: Yang
authors.forename: Michele M
authors.initials: MM
authors.lastname: Wood
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D044466:Asian People; D003144:Communication Barriers; D005006:Ethnicity; D005239:Fear; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000208:ethnology; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D007802:Language; D008297:Male; D002052:Myanmar / Q000208:ethnology; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D012036:Refugees; D012923:Social Class; D063508:Social Discrimination; D057545:Social Stigma; D012959:Socioeconomic Factors; D013785:Thailand / Q000453:epidemiology; D014171:Transients and Migrants
chemical_list: D044966:Anti-Retroviral Agents
keywords: HIV treatment; antiretroviral therapy; case study; ethnic minorities; migrant populations; rapid ethnographic assessment