在申请移民澳大利亚时使用次优抗逆转录病毒疗法:一个案例系列

IF 1.8 4区 医学 Q3 INFECTIOUS DISEASES
Sexual health Pub Date : 2024-04-29 DOI:10.1071/sh24028
Daniel Tran, Brent Allan, Alexandra Stratigos, Darryl O’Donnell, Dash Heath-Paynter, Aaron Cogle, Jason J. Ong
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引用次数: 0

摘要

背景澳大利亚对申请永久居留权(PR)的艾滋病病毒感染者(PLHIV)规定了限制条件,包括 10 年内医疗费用支出低于 51,000 澳元。一些艾滋病病毒感染者选择了次优且更便宜的抗逆转录病毒疗法(ART),以增加获得永久居留权的机会。我们整理了一个病例系列,对因签证问题而接受次优抗逆转录病毒疗法的 PLHIV 进行了研究。方法我们确定了所有在澳大利亚申请 PR 的患者,他们在 2022 年 7 月至 2023 年 7 月期间从墨尔本性健康中心获得了奈韦拉平、依非韦伦或齐多夫定。两名研究人员从临床记录中提取了病理结果以及与患者希望继续接受次优抗逆转录病毒疗法有关的心理问题的详细记录。结果我们发现了六名来自亚洲和欧洲国家的患者,他们的平均年龄为 39 岁。三名患者使用依非韦伦,三名使用奈韦拉平。所有患者都希望继续使用廉价的次优抗逆转录病毒疗法,以保持在签证费用阈值以下,他们认为这将有助于他们的申请。其中四人因签证被拒、上诉期限和漫长的签证申请过程而感到紧张和焦虑。结论尽管可以获得更有效、更安全的抗逆转录病毒疗法,但我们仍发现一些患者选择继续接受廉价的抗逆转录病毒疗法,以增加获得澳大利亚签证的机会,这可能会危及他们的健康。我们发现有大量证据表明患者存在压力和焦虑。澳大利亚目前的移民政策和法律歧视艾滋病毒携带者,危害公众健康,因此有必要对这些政策和法律进行审查和修订。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The use of suboptimal antiretroviral therapy when applying for migration to Australia: a case series
Background

Australia imposes restrictions for people living with HIV (PLHIV) applying for permanent residency (PR), including spending less than AUD51,000 on medical costs over 10 years. Some PLHIV opted for suboptimal and cheaper antiretroviral therapy (ART) regimens to increase their chances of receiving PR. We collated a case series to examine PLHIV on suboptimal ART because of visa issues.

Methods

We identified all patients applying for a PR in Australia who obtained nevirapine, efavirenz or zidovudine between July 2022 and July 2023 from the Melbourne Sexual Health Centre. Pathology results and records detailing psychological issues relating to the patients’ wishes to remain on suboptimal ART were extracted from clinical records by two researchers.

Results

We identified six patients with a mean age of 39 years migrating from Asian and European countries. Three patients used efavirenz, and three used nevirapine. All desired to remain on cheaper, suboptimal ART to stay below visa cost thresholds, which they considered to aid favourably with their application. Four displayed stress and anxiety arising from visa rejections, appeal deadlines and the lengthy visa application process.

Conclusions

Despite access to more effective and safer ART, we identified patients who chose to remain on cheaper ART to improve chances of obtaining an Australian visa, potentially putting their health at risk. We found significant evidence of stress and anxiety among patients. There is a need to review and revise current migration policies and laws in Australia that discriminate against PLHIV and jeopardise public health.

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来源期刊
Sexual health
Sexual health 医学-传染病学
CiteScore
2.30
自引率
12.50%
发文量
121
审稿时长
6-12 weeks
期刊介绍: Sexual Health publishes original and significant contributions to the fields of sexual health including HIV/AIDS, Sexually transmissible infections, issues of sexuality and relevant areas of reproductive health. This journal is directed towards those working in sexual health as clinicians, public health practitioners, researchers in behavioural, clinical, laboratory, public health or social, sciences. The journal publishes peer reviewed original research, editorials, review articles, topical debates, case reports and critical correspondence. Officially sponsored by: The Australasian Chapter of Sexual Health Medicine of RACP Sexual Health Society of Queensland Sexual Health is the official journal of the International Union against Sexually Transmitted Infections (IUSTI), Asia-Pacific, and the Asia-Oceania Federation of Sexology.
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