Abstract
Despite current enthusiasm for biomedical approaches to HIV prevention, many populations at heightened risk have limited access to preventive health services of any kind. This situation is particularly true for labor migrants. This chapter reviews the factors that produce HIV vulnerability for migrant populations, in all their diversity, and develop further the notion of the meso-level as the focus of structural analysis and collective action. It does this via brief case studies focused on labor migrants from three countries from distinct geographic and sociocultural regions of the world, including Mexico, Nigeria, and Vietnam, which examine the ways in which policies including those related to mobility, access to housing, labor rights, and access to health care could be modified to enhance the HIV vulnerability-producing circumstances in which many migrants live and work. These case studies illustrate that the inequalities faced by migrants reside not in one policy but in many, and thus offer multiple strategies to addressing these inequalities. Thus, intervening on meso-level policies that are specific, modifiable, and shape HIV vulnerability offers a concrete and promising structural approach to HIV prevention.
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Hirsch, J.S., Philbin, M.M., Smith, D.J., Parker, R.G. (2018). From Structural Analysis to Pragmatic Action: The Meso-level Modifiable Social Determinants of HIV Vulnerability for Labor Migrants. In: Kerrigan, D., Barrington, C. (eds) Structural Dynamics of HIV. Social Aspects of HIV, vol 4. Springer, Cham. https://doi.org/10.1007/978-3-319-63522-4_2
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