LAUSR

OBJECTIVE Explore the implications of Brexit from the perspectives of British citizens with HIV residing in Spain (BHIV-RS). DESIGN UK is due to leave the EU on 31 October 2019, creating uncertainty on the rights enjoyed by EU citizens abroad. Spain is one of the main concerns because almost 30% of the British citizens living in others EU countries live there. Several legal consultations of BHIV-RS have come to the HIV Legal Clinic of the University of Alcalá asking about the right of access to ART after Brexit. METHODS We have studied the healthcare regulatory framework at the European and Spanish levels. This regulatory framework guarantees the right to healthcare in any country of the EU on equal terms with the citizens of the hosting country. RESULTS If the Withdrawal Agreement is agreed, then reciprocal healthcare rights of BHIV-RS will continue. Without Withdrawal Agreement BHIV-RS will have to rely on any rights which they may be able to claim under the Spanish system unless there is a bilateral agreement. In Spain, access to ART is free and granted by NHS but, constitutionally, who is entitled and their healthcare benefits can be limited, as happened in 2012 with migrants. CONCLUSIONS The events documented in relation to migrants provide a cautionary tale. While some BHIV-RS may have access to ART through private health insurance for the most part of them obtaining ART can be difficult and expensive particularly if they have related co-morbidities. A likely consequence would be the worsening of individual health (late presentations for HIV diagnosis increases the risk of dying) and public health (increases the transmission rate).