"Who are you and what are you doing here?": Social capital and barriers to movement along the HIV care cascade among Tajikistani migrants with HIV to Russia
Document Type
Article
Publication Date
1-1-2021
Abstract
Tajikistani migrants who work in Russia and acquire HIV seldom receive HIV treatment while in Russia. Barriers to engagement in the HIV care cascade were identified from in-depth, semi-structured interviews with purposefully sampled Tajikistani migrants (n = 34) with HIV who had returned from Russia. Data were analyzed using thematic analysis, drawing from Putnam's theory of social capital, showing how bridging and bonding social capital relate to poor engagement in HIV care. We identified three barriers to Tajikistani migrants' movement through the HIV care cascade: (1) Russia's migration ban on people with HIV interrupts social capital accumulation and prevents access to HIV treatment within Russia; (2) mistrust of authority figures, including healthcare providers, leads to avoiding treatment and harm-reduction services upon their return to Tajikistan; and (3) because of pervasive discrimination, Tajikistani migrants form weak social ties while in Russia, which exacerbates risk, including with Russian citizens, and deters engagement with HIV care. Deploying a treatment as prevention strategy and abolishing Russia's ban on people with HIV would improve both individual and public health.
Keywords
HIV treatment cascade, Eastern Europe and Central Asia, HIV, Migration, Social capital, Stigma, Discrimination
Divisions
ceria
Funders
United States Department of Health & Human Services National Institutes of Health (NIH) - USA [Grant No: D43 TW010540; T32 MH020031; R01 DA033679; K24 DA017072],Yale-Collaborative Action Project (Y-CAP) award from the Yale School of Public Health
Publication Title
AIDS and Behavior
Volume
25
Issue
10
Publisher
Springer
Publisher Location
233 SPRING ST, NEW YORK, NY 10013 USA