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Background: Migrant populations from countries with generalised HIV epidemics make up a significant proportion of all HIV/AIDS cases in many European Union and European Economic Area (EU/EEA) countries, with heterosexual transmission the predominant mode of HIV acquisition. While most of these infections are diagnosed for the first time in Europe, acquisition is believed to have predominantly occurred in the home country. A proportion of HIV transmission is believed to be occurring post-migration, and many countries may underestimate the degree to which this is occurring. Our objectives were to review the literature estimating the proportion of migrants believed to have acquired their HIV post-migration and examine which EU member states are able to provide estimates of probable country of HIV acquisition through current surveillance systems. Methods: A systematic review was undertaken to gather evidence of sexual transmission of HIV within Europe among populations from countries with a generalised epidemic. In addition, national surveillance focal points from 30 EU/EEA Member States were asked to complete a questionnaire about surveillance methods and monitoring of the likely place of HIV acquisition among migrants. Results & discussion: Twenty-seven papers from seven countries were included in the review and 24 countries responded to the survey. Estimates of HIV acquisition post-migration ranged from as low as 2 % among sub Saharan Africans in Switzerland, to 62 % among black Caribbean men who have sex with men (MSM) in the UK. Surveillance methods for monitoring post-migration acquisition varied across the region; a range of methods are used to estimate country or region of HIV acquisition, including behavioural and clinical markers. There is little published evidence addressing this issue, although Member States highlight the importance of migrant populations in their epidemics. Conclusions: There is post-migration HIV acquisition among migrants in European countries but this is difficult to quantify accurately with current data. Migrant MSM appear at particular risk of HIV acquisition post-migration. Countries that identify migrants as an important part of their HIV epidemic should focus on using an objective method for assigning probable country of HIV acquisition. Robust methods to measure HIV incidence should be considered in order to inform national prevention programming and resource allocation. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The involvement of individuals and communities in health decision‐making is enshrined in WHO policies. However, migrant groups are under‐represented in health decision‐making processes. Our aim was to explore migrants' involvement in health policy, service development and research in the WHO European Region to identify levers for inclusive and meaningful practice. METHODS: We conducted a narrative review of grey literature and peer‐reviewed research on migrants' involvement in health decision‐making across the 53 countries in WHO Europe. We searched for articles published in English between 2010 and the present in two electronic databases (PubMed, Scopus), IOM MIPEX Health Strand country reports, the EU SOPHIE project and using a Google advanced search. Findings were analysed descriptively and using Normalisation Process Theory to investigate levers and barriers to implementation of policy into practice. RESULTS: Of 1,444 articles retrieved, 79 met the inclusion criteria. We identified 20 policies promoting migrants' involvement, but national‐level policies were present in only two countries. We identified 59 examples of migrants' involvement in practice from half of the WHO Europe countries (n = 27). Our Normalisation Process Theory (NPT) analysis of 14 peer‐reviewed empirical papers found that participatory research approaches are a lever to putting policy into practice in a meaningful way. CONCLUSIONS: Migrants' involvement in health decision‐making requires explicit national policies that are implemented evenly across policymaking, service provider and research activities in all countries in the WHO European Region. Participatory approaches to involvement activities are encouraged because they are a lever to perceived barriers to migrants' involvement. [ABSTRACT FROM AUTHOR]

Introduction: As the burden of migration to Europe increases, Greece is in a critical geographical crossroad and despite its longstanding financial troubles, is now mapping new paths for coping with modern immigration influx via adhering to improved social status of refugees and migrants. In terms of access to health services by refugees and immigrants in Greece, it should be noted that the institutional framework concerning access has been relatively restricted until recently. Aim: The main objective of this paper is to explore factors associated with nursing and contemporary migration and also to present an overview of the European and Greek policies and initiatives to protect migrants' health. Method: A critical literature search was performed, seeking key material and benchmark policy statements exploring and explaining the complexities and the challenges associated with migration per se and the impact on people's health. Findings-Discussion: Findings are grouped and discussed further under five pillars, i.e.: Immigration in Europe in Recent Years, Configuring Europe's migration policy to address first migration rates, How is Europe securing migrant's health, Health care provision and utilization for migrants in Europe and Health care provision and utilization for migrants in Greece. Overall, it can be argued that the refugee crisis had a major impact on the Greek NHS and that the influx of forcibly displaced people raised critical issues concerned health care provision including services for mental comorbidities and psychosocial support. Yet, efforts are made to adjust policy and practice in the light of meeting health needs for migrants despite economic limitations, which are affecting both locals and refugees alike. Conclusions: Nursing, in this turbulent health provision environment is expected to provide health interventions addressed to migrants. As the spectrum of migration into Europe continues due to various political, social and financial complexities, the need for societal responses including appropriate policy implementation and relevant nursing education is essential. Thus, migration will continue to pose challenges to society and to health in Greece and beyond. Only through continuous attentiveness will it be possible to identify, and then avoid or reduce health disadvantages faced by persons with a migration background. [ABSTRACT FROM AUTHOR]

Migrants comprise a growing proportion of European populations. Although many are healthy, those who do need healthcare often face barriers and the care they receive may be inappropriate to their needs. This paper summarises good practices identified in a review of health services for migrants in Europe. Governments should ensure that migrants are entitled to health services, that the services are appropriate to their needs and that data systems are in place to monitor utilisation and detect inequities. Health services should adopt a 'whole organisation approach', in which cultural competence is viewed as much as a task for organisations as for individuals. Health workers should take steps to overcome language, social and cultural barriers to care. In each case, existing examples of good practice are provided. At a time when support is growing in some countries for political parties pursuing anti-immigrant agendas and governments in all countries are pursuing austerity policies, there is a greater need than ever for the public health community to ensure that migrants have access to services that are effective and responsive to their needs. [ABSTRACT FROM AUTHOR]