Key findings from the 2023 'ACT NOW on Global HIV Migration, Mobility and Health Equity' community forum.

Background People living with HIV continue to face laws, policies, and practices that impact their potential for travel and migration. These laws include: mandatory HIV testing and involuntary disclosure of HIV; lack of access to affordable HIV-related health care, treatment and counselling during the migration process; deportation of foreign nationals living with HIV; and restrictions on the length of stays. Methods HIV migration laws were the topic of a half-day community forum held as part of the 12th International AIDS Society Conference on HIV Science held in Brisbane, Australia, in July 2023. Over 150 delegates attended and, after a series of presentations, delegates were invited to participate in structured, facilitated conversations about issues related to policy, health and law concerning migration of people living with HIV. In this paper, we report on key themes from those discussions and identify areas for ongoing investigation. Results Advocates recommended the removal of unfair and unjust migration laws and policies that contribute to HIV stigma and discrimination; updated migration policies that reflect the current context and cost of biomedical approaches to HIV management and prevention; expanded and equitable access to HIV-related care regardless of migration or residency status; and the development of advocacy networks to promote changes to migration policies. Conclusions Laws limiting the migration of people living with HIV actively discourage individuals from seeking HIV testing, treatment and care. Ultimately, restrictive migration laws and policies undermine global efforts to end AIDS as a public health concern and to virtually eliminate HIV transmission by 2030.

[Knowledge of stroke problems among adults in Poland]. / Znajomosc problematyki udarowej wsród osób doroslych w Polsce.

An inquiry questionnaire was given to 180 adults without a history of stroke. The questions concerned the problem of stroke. The responders were aged from 15 to 82 years (mean 48 years). They were asked about risk factors for stroke, symptoms preceding stroke, behaviour of stroke witnesses. A correct definition of stroke was given by 86.7% of the responders. Only a small proportion of them knew risk factors for stroke (27.8% knew that one of them was hypertension, 6.1% gave smoking, 4.4% diabetes as risk factors). Although 93.9% knew that in face of stroke physician or ambulance service should be called, 6.1% thought that it would be sufficient to lie down or take paracetamol. The inquiry showed that the knowledge of risk factors for stroke is insufficient in the Polish adult population who not yet had cerebrovascular disturbances. It seems advisable to deliver an education programme in mass media on stroke prevention and its management in case of its development.

[How do general practitioners proceed on initial contact with patients after cerebrovascular ischemia?]. / Jak postepuje lekarz pierwszego kontaktu z chorymi z zaburzeniami krazenia mózgowego?

The reported analysis of an inquiry study of first-contact physicians was carried out for establishing how the manage cases of ischaemic stroke and transient ischaemic accident (TIA). The inquiry questionnaire containing questions related to the management of these patients and outpatient diagnosis of patients after stroke or TIA was sent to general practitioners in 4 regions of the country. The form was returned by 159 out of 300 physicians, mostly those working in towns (90.6%). From 53.5% to 64.8% of physicians referred patients with symptoms suggestive of stroke to hospitals, less often were referred those with vision disturbances. Antiplatelet drugs were prescribed to patients with cerebral circulation disturbances by only 12% to 20.3% of the physicians. Only 46.8% of the physicians used anticoagulants as secondary prevention after cerebral embolism from the heart. In patients treated with anticoagulants INR was checked every 2 weeks by 50.9% physicians. Only 42.8% of the physicians referred the patients for USG examination of neck arteries. The analysis showed that too few first-contact physicians referred stroke cases to hospital and too few prescribed antiplatelet drugs for TIA. Anticoagulants were used insufficiently for secondary prevention after cerebral embolism from the heart. There is much to do in stroke cases for management and prevention.