Immigrants in Estonia: a risk assessment to involve this key group into HIV and co-infections services

Grantee

ECOM – Eurasian Coalition on Health, Rights, Gender and Sexual Diversity, Estonia

Main applicant and principal investigator

Maksym Kasianchuk, M&E Coordinator, ECOM

Deputy applicant

Kristi Rüütel, Scientific Secretary, National Institute for Health Development, Tallinn, Estonia

Background

There has been an increase in the number of migrants, refugees and asylum seekers arriving to Estonia over the past five years, particularly migrant workers (legal or illegal). Unpublished data indicate that a considerable proportion of HIV and hepatitis B and C virus cases are diagnosed in migrant populations. However, there is limited information about the extent to which these population groups are accessing available medical and social services and the barriers they experience.

Objective

The study objective is to contribute to the prevention of HIV and co-infections (viral hepatitis and sexually transmitted infections) in different migrant sub-populations in Estonia by studying risk factors for HIV and co-infections, mapping needs and gaps in existing health services (including prevention and social services) and propose changes to existing service delivery models that would make it possible to reach migrants with HIV and co-infection prevention and treatment.

Methods

The objectives will be explored through use of qualitative methods (semi-structured interviews and focus group discussions with representatives of different migrant subgroups and NGO staff). The respondents (25 in total) will be recruited through snowball sampling initiated by relevant community organizations providing services to migrants in Estonia and should represent a mixture of migrant groups (by country of origin (Russia, Ukraine, other), income level and legal status (legal/illegal and asylum seekers/refugees)).

Output / impact

The study will provide recommendations on changes to the system of existing services for migrants, aiming for this group to be covered with HIV and co-infections prevention and treatment. The study results will be discussed with a wide range of key national stakeholders, including the Health Board, the Parliament, Ministry of Foreign Affairs, Ministry of Social Affairs, Ministry of the Interior, National Institute for Health Development, trade unions, police and NGOs working with national minorities/HIV and with asylum seekers/migrants, and are expected to serve as input into developing revised national policies and guidance for the management of HIV and co-infections among migrants. Additionally, the study results will provide insight into any required adjustments of existing national surveillance systems for HIV and co-infections (viral hepatitis and STIs).