Positive in foreign land: Initiation, Adherence and Default to ART among cross-boarder Migrant PLHIVs from developing countries of South Asia

Year 2011 witnessed two milestones acknowledging issues of “International-Migrant-PLHIVs” globally, Political Declaration HIV/AIDS which targeta at ‘eliminating HIV-related restriction on entry, stay and residence by 2015’ and US president ‘ending the ban prohibiting PLHIV from entering America.’ India-Nepal and India-Bangladesh are two prominent cross-border migration corridors, prior being open-boarder and later an illegal gateway. This study explores ART related issues of Nepali and Bangladeshi PLHIVs residing in Mumbai. Data is collected through in-depth-interactions and FGDs with PLHIVs during July-August, 2012. Unavailability of entitlements including bank account results in disposable cash migrants usually spend on various risk-behavior. Despite free ART services at India, factors like self-stigma, fear of discrimination at and losing employment, language incompatibility, lack of local identity documents/proof hurdles treatment initiation. Secrecy regarding nationality to avoid being deported restricts the Bangladeshis. Non-Indian status often demands extra effort, time, and additional formalities, sometimes-even money. Unfavorable provider’s attitude, side effects leads to default and non-disclosure to spouse and family and unavailability of ART when visiting native country result even in discontinuation.