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| Abstract #407 - Well Being and Life Expectancy | ||||
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Session: 25.6: Well Being and Life Expectancy (Parallel) on Tuesday @ 11.00-13.00 in Raval Chaired by Xiaming Li, Carlos Mur Authors: Presenting Author: Mrs Adeline TOULLIER - AIDES, France |
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| Additional Authors: | ||||
| Aim: Contrary to developing countries, access to ARVs is guaranteed in high income countries. Since 1998, France has provided residence permits for health reasons, which ensure access to work and health care. Even if such a right only affects 6,000 PLWHA/year, it is not satisfactorily enforced. To evaluate the effectiveness of this right, that underwent an important legislative restriction in June 2011, AIDES, French HIV-CBO, implemented a data collection platform about this administrative procedure and its impact on the QOL of PLWHA. | ||||
| Method / Issue: Since 2010, a national online platform, based on the needs expressed by affected people and NGO activists, was set up. The objectives were: 1) capacity building (information about the ?correct? administrative procedure); 2) adapting advocacy in relation to noticed dysfunctions. Data concerned socio-demographics, managing the procedure effectively and qualitative aspects (e.g. discouragement). | ||||
| Results / Comments: More than 350 situations were collected among October 2010 and April 2013. It must be noted that new situations are included every day. Most of the cases concern people from Sub-Saharan Africa, but there are also cases regarding people from Eastern Europe and South America. Data show strong differences regarding law enforcement depending on the administrative regions as well as an important disengagement of health authorities during the procedure, since June 2012. Major dysfunctions at the prefectures are non-respectful/aggressive attitudes and waiting in line for >5 hours. Although there is an official document check-list, in 1/3 of cases, prefecture agents ask for documentation illegally, preventing in some cases to submit the application for the residence permit. Health status confidentiality was violated in 1/3 of cases. While the request for the permit was being processed (in some cases during 12 months even if the legal delay is 4 months), in 1/2 of cases, the mandatory receipt was not provided by the prefecture. The taxes for obtaining the residence permit have significantly increased since 2011, preventing to those with limited economic resources from obtaining the permits. Finally, it must be stated that the refusal of residence permits; detentions and deportation of foreign PLWHA and/or hepatitis have increased since July 2012, mainly in the Paris region, where migration and HIV prevalence?s are the biggest. Legal remedies were in vain most of the times, even when accompanied by public actions, not reaching to avoid expulsions. These dysfunctions (e.g. delays, rejections) have a dramatic impact on the QOL of PLWHA: in 50% of cases we observed discouragement and exhaustion and negative effects on financial conditions and healthcare. | ||||
| Discussion: This platform allows to objectively observe the importance and extent of prefectural failures, particularly in such a secretive setting, where no official data are provided. These results will enable us to develop and strengthen advocacy strategies to defend this residence permit, especially when the next immigration bill will be debated in the parliament by the end of 2013. This tool, but especially this right, can be developed and encouraged in other high income countries. | ||||
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