Access to HIV Services for Mobile and Migrant Populations in Antigua

Mount St. John’s Medical Centre
Michael’s Mount
This is the main hospital in Antigua where most persons go for care. The target
population is the general population and outreach is not done to any particular population.
Hundreds of patients are seen monthly in the Emergency Department and Outpatient
clinics. Persons with a Medical Benefit card are entitled to most services with a small copay
of EC$20 or EC$30 with the exception of persons who are 16 and under or 60 or
over who are Antiguan, can be seen free. Persons not holding a Medical Benefit card or
private insurance must pay all the fees out of pocket and this is frequently a problem as
many persons from the migrant population are unable to pay the bills.
The hospital does not provide a lot of preventative education, but free condoms are
distributed in the Social Services department, the maternity Ward and some other places.
Pre and post HIV test counseling is provided. In the counseling office, approximately
10 - 15 migrants are seen monthly for various reasons. There is an Infection control
Unit which overseas most HIV and AIDS related matters. The person heading that
department as well as the social worker, counselor, Employee Health Nurse and other
nurses are trained in working with vulnerable populations like trafficked persons and also
in VCT. When a client is first diagnosed, they are referred to the Social Services
Department who contacts the AIDS Secretariat and 3H network. The AIDS Secretariat
refers them to the clinical Care Coordinator and 3H provides support.
Members of the migrant population and vulnerable persons are also referred for free
treatment. There have been about 5 cases of trafficked sex workers coming through the
emergency department and 3 were referred to Gender Affairs who were able to assist
them with retrieving their passports and leaving the island freely while 2 absconded after
medical care was administered.
All staff is exposed to training on Diversity and Cultural Competence at orientation;
however, there are still some complaints of stigma and discrimination against members of
48