Access to HIV Services for Mobile and Migrant Populations in Antigua

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men who have sex with men and commercial sex workers because that is not the focus of the clinic and there are no projected plans to offer any such services. Other services offered include HIV and AIDS education, prevention and care and treatment. There is also on staff an interpreter who caters to the Spanish speaking population. The staff at the Women’s clinic has not received training in dealing with vulnerable populations nor have they received training in diversity and cultural competence. On staff there is a trained receptionist and a registered nurse. The clinic receives many repeat clients for antenatal care and of these repeat clients, 25% are from the migrant population. The clients who are HIV positive are referred to AIDS Secretariat and to the AIDS Clinical Care Coordinator. Referrals to the clinic are generally made by practitioners. Counselling is offered before and after HIV testing. The clinic sees approximately 200 clients monthly of which 50 are a part of the migrant population. Although they might be, it is not known for sure how many are MSM or CSW as that question is not asked. Dr. Nabis Sanchez Medical Doctor Gambles Terrace Dr. Sanchez is a bilingual – Spanish and English speaking physician who is originally from Cuba. She is located on the outskirts of St. John’s, two minutes’ drive from the Popeshead Street Area hotspot and about three minutes derive from the Antigua Planned Parenthood Association (Family Planning). She provides general services to all persons but she provides but is utilized a lot by the Spanish-Speaking population, including many sex workers. While there are charges for her services, some clients have reported being able to get discounted fees. She has even provided pro bono services to clients referred 63
to her by the social worker at the Mount St. John Medical Center. She has attended training on dealing with vulnerable populations and as part of her practice she offers HIV Counselling. Other Guyana Consulate Mr. Robert Reis – Honorary Consul Corn alley & Long Street Mr. Reis is the representative in Antigua for the Guyana government as his target population to offer services to are the Guyanese nationals residing in Antigua and Barbuda. He has been functioning in this capacity from August 2003. He offers support to the residents by listening to their concerns and passing them over to his supervisors in Guyana. He is also responsible for the renewing of passports and birth certificates. Support services are free and the only costs attached to his services are the costs to renew official documents. Therefore, the only barrier to services is if a client does not have the funds, but he cannot control that as there is no fund to assist those with limited cash. Clients give their identifying information and when necessary, confidentiality is maintained if a client discloses personal information. He has been called to intervene for clients with Immigration issues and does the best he can to advocate for clients. He is also aware that a number of Guyanese migrants work as sex workers, but does not interfere unless something is required of him. He was asked to help to find funds to bury one Guyanese young lady who died from AIDS related complications and he did so, but he does not education or provides any other HIV or AIDS related services. 64
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APRIL 2012 A Mapping Study on Acces
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FACTS ABOUT ANTIGUA • Capital - S
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5. Design of Survey Tools………
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3.2.4. HIV Information and Testing
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List of Acronyms AIDS ABHAN APPA AR
Page 11 and 12:
Executive Summary Background Due to
Page 13 and 14: There is clearly a lot of stigma an
Page 15 and 16: Background to Study A quick search
Page 17 and 18: Table 1 - Population by Parishes Pa
Page 19 and 20: Relevance of Study Several reports
Page 21 and 22: ‣ Desk Review - a compilation of
Page 23 and 24: This review attempts to examine som
Page 25 and 26: Kempadoo (2010) recalls that “Ant
Page 27 and 28: Table 6 - Remittances as Percentage
Page 29 and 30: members of the sex-worker populatio
Page 31 and 32: use of intravenous drugs. She state
Page 33 and 34: population about their role in the
Page 35 and 36: CHAA, based on an Inter-American Pa
Page 37 and 38: The Government of Antigua and Barbu
Page 39 and 40: Population Services International (
Page 41 and 42: MAPPING METHODOLOGY Population Due
Page 43 and 44: Design of Survey Tools The survey f
Page 45 and 46: STAKEHOLDERS REPORT For this projec
Page 47 and 48: AIDS Secretariat/NAP office Redclif
Page 49 and 50: Mount St. John’s Medical Centre M
Page 51 and 52: suspicion in the department of some
Page 53 and 54: services as this does act as a barr
Page 55 and 56: Non-Governmental Organizations (NGO
Page 57 and 58: and MSM’s are referred to Directo
Page 59 and 60: in navigating the health care syste
Page 61 and 62: Questionnaires are issued and there
Page 63: There are costs attached to the pro
Page 67 and 68: funding, but they are still very fu
Page 69 and 70: Encouragement should be made to civ
Page 71 and 72: Where are the places that you provi
Page 73 and 74: Do you collaborate with any other a
Page 75 and 76: MSM Survey and Focus Group Report M
Page 77 and 78: Free Condoms Figure 13- Free condom
Page 79 and 80: Table 9- Reasons for not having an
Page 81 and 82: care. Some had no answer as they ha
Page 83 and 84: coming out or dealing with the stig
Page 85 and 86: Misconceptions At least 90% of the
Page 87 and 88: Create a job bank - having a job co
Page 89 and 90: 57.8% of the young ladies work on t
Page 91 and 92: them to read. “Only CHAA really w
Page 93 and 94: It is quite evident that fear has c
Page 95 and 96: care and an inviting friendly atmos
Page 97 and 98: They need to be able to access a gy
Page 99 and 100: Type of facility frequented for tre
Page 101 and 102: Their expectations for their core g
Page 103 and 104: General Discussion and Conclusion T
Page 105 and 106: Many of the ladies expressed a desi
Page 107 and 108: Policy Aspects The National
Page 109 and 110: target population. Purpose: this wo
Page 111 and 112: information on existing testing sit
Page 113 and 114: ANNEX _____________________________
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Support Clothes Populations Served
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Demographic 8 participants Sex: Mal
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3. Where are the places/spots that
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that most MSM’s are very particul
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‣ Men’s health care clinic - wh
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‣ Confidential organizations wher
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French 3 3.1 Other 0 0.0 Total 105
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their country as a group. 5.2% of t
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Partner History Partners in Antigua
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Sex for pay (how many of the sexual
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Table No. 25- Partner has spouse or
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Condom Supply The majority of the p
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How to use condoms/Instructional co
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percentage when one considers that
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Ability to pay for HIV testing Tabl
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They don’t speak my language 0 0.
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Never 15 15.7 Don’t recall 24 25.
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Other foreigners are there 12 12.6
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Facility not clean and tidy 4 4.2 O
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Sometimes 24 25.2 Rarely 16 16.8 Ne
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Responses Number Percentage Public
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No response 1 1.0 Total 95 99.8 Tab
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Focus Group Responses 1- What are s
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5- What are some of the factors tha
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oyfriends. One participant also sai
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Marital Status: All were unmarried
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They face a lot of difficulties whe
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Figure35 - Breakdown of country of
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Table No. 61- Length of time in Ant
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groups of other persons from their
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Number of Respondents Number of Res
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Table 70- Showing how clients are c
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Condom Supply When asked where they
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How to use condoms /Instructional c
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Table 79- Showing amount of persons
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discrimination. Some 59.6% of the r
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Reasons for not having had a recent
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Availability of HIV testing or educ
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Table 90- Showing their perception
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Reasons for not recommending facili
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DISCRIMINATION Discrimination faced
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“They call me Spanish and they al
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Back to school program Back to scho
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Training center where we can learn
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Disagree 91 79.8 Don’t know 20 17
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7. What social connections do you h
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c. Between 1and 3 months ago g. Nev
Page 209 and 210:
. Stigma and discrimination e. Faci
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CSW INTERVIEW SHEET Date of Intervi
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18. In the past 12 months, have you
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36. Would you go back yourself or r
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52. If you could implement a progra
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The CARICOM single Market and Econo
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CHAA (2012) International Day: Stop
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Thomas-Hope, Elizabeth (1986),”Tr
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Access to HIV Services for Mobile and Migrant Populations in Antigua

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