Migrant populations face increased HIV vulnerabilities, including limited access to antiretroviral therapy. Civil conflict in Myanmar has displaced thousands of people from the minority Shan ethnic group into northern Thailand, where they bear a disproportionate HIV burden. To identify barriers and facilitators of antiretroviral therapy use in this population, we conducted a rapid ethnographic assessment and case study with a clinical sample of Shan migrants receiving treatment for HIV in a district hospital in Chiang Mai, Thailand, Thai nurses providing their care, and health care administrators (n = 23). Barriers included fears of arrest and deportation, communication difficulties, perceived social marginalization, limited HIV knowledge, and lack of finances. Facilitating factors included hospital-based migrant registration services and community outreach efforts involving support group mobilization, referral practices, and radio broadcasts. These findings provided a contextualized account to inform policies, community interventions, and nursing practice to increase treatment access for minority migrant groups. © 2016 Association of Nurses in AIDS Care

Case study Migrant populations Antiretroviral therapy rapid ethnographic assessment HIV treatment ethnic minorities

Communication Barriers social exclusion HIV Infections refugee Thailand nursing practice human highly active antiretroviral therapy Refugees epidemiology Antiretroviral Therapy, Highly Active Asian continental ancestry group Ethnic Groups communication disorder ethnic group Anti-Retroviral Agents antiretrovirus agent language administrative personnel ethnology Human immunodeficiency virus Humans migrant male female patient referral Socioeconomic Factors socioeconomics clinical article Myanmar Social Stigma public hospital Health Knowledge, Attitudes, Practice support group adult migration patient attitude radio Patient Acceptance of Health Care Transients and Migrants social class social discrimination mobilization Fear registration attitude to health Health Services Accessibility finance health care delivery