On Migration and Health

This study examined the sexual and reproductive health (SRH) status and needs of Filipino women working abroad as domestic workers, with the goal of generating baseline data to inform and strengthen relevant policies and programs.

Using a mixed-methods approach, combining a probability-sampled survey with focus group discussions, the research explored participants' personal profiles, motivations for migration, working conditions, and SRH concerns.

The findings reveal significant gaps in health knowledge and access. While most women were broadly aware of reproductive tract infections and HIV/AIDS, many harbored critical misconceptions — for instance, believing that cleanliness, abstinence from penetrative sex, or opposite-sex partnerships alone could prevent AIDS. Knowledge of fertility and family planning was similarly limited, with roughly three in five participants holding mistaken beliefs about when pregnancy is most likely to occur during a woman's cycle, and fewer than one in five reporting use of any family planning method. Among those who disclosed romantic relationships abroad, most did not practice safe sex.

The study identifies structural and systemic barriers as root causes of these gaps. Economic hardship and lack of sustainable employment at home are the primary drivers pushing women into overseas domestic work. Abroad, their exclusion from formal labor force recognition in many host countries means they are often denied social security and medical benefits — severely limiting their access to health services and information. Combined with poor health-seeking behavior, these factors leave migrant domestic workers particularly vulnerable.

The researchers conclude by calling on governments, NGOs, and other stakeholders to address these vulnerabilities through improved pre-departure health education, stronger protections in overseas work contracts, and expanded access to reproductive health services for this population.

This publication documents the lived experiences of migrant workers across Asia who are living with HIV. Drawing on eleven life stories gathered from participants across six origin countries — Bangladesh, India, Indonesia, the Philippines, Sri Lanka, and Vietnam — the study offers a deeply human portrait of how migration and HIV intersect, going beyond statistics to capture the voices of those directly affected.

The participants, seven men and four women, worked across destinations including Saudi Arabia, Singapore, the UAE, South Korea, and Japan, mostly during the 1990s. Most came from modest educational and economic backgrounds and migrated primarily to support their families.

The research identifies four interlocking factors that heightened HIV vulnerability among migrant workers: personal factors such as low HIV awareness; economic pressures that pushed some toward transactional sex; weak or poorly implemented health policies at both origin and destination countries; and socio-cultural dynamics, particularly gender inequality and sexual norms that discouraged condom use and enabled abuse.

Nearly all participants contracted HIV through unprotected sexual intercourse, and eight were diagnosed through mandatory health screening at their destinations. Five were subsequently deported. Beyond the diagnosis itself, the study traces its cascading consequences — psychological trauma compounded by the absence of counseling, economic devastation for workers and their dependents, and the profound social toll of HIV-related stigma and discrimination at the family and community level.

This publication highlights how migrant workers occupy a uniquely vulnerable position at the intersection of poverty, displacement, and social marginalization, and calls for stronger, more compassionate policies around HIV prevention, treatment, and support for this population.

This qualitative study examined the HIV vulnerabilities of Filipino women migrant workers (OFWs) in the Arab States. It forms part of a seven-country regional research initiative supported by the UNDP Regional Center Colombo, aiming to generate evidence on the specific risks faced by women migrants across the full migration cycle from pre-departure to employment abroad and eventual reintegration.

The study drew on a desk review of existing literature and in-depth interviews with six women OFWs who had worked in Arab states, four of whom were living with HIV. Destinations covered included Lebanon, Dubai, and Abu Dhabi.

Findings reveal that vulnerability to HIV operates at multiple, intersecting levels. Individually, low awareness of HIV transmission and prevention compounded by a false sense of personal immunity led participants into unsafe sexual practices. Structurally, the Pre-Departure Orientation Seminar (PDOS) proved inadequate and inconsistently implemented, while mandatory medical testing was conducted without proper counseling or informed consent. Economic pressure drove some women into exploitative relationships, and in the worst cases, into tolerating rape in exchange for financial support. Harsh living and working conditions, loneliness, and isolation further pushed women toward relationships that heightened their exposure to infection.

Paradoxically, the study found that greater freedom and mobility such as having days off and disposable income correlated with higher HIV risk, while those confined to employers' homes had less opportunity for sexual exposure, though they remained vulnerable to abuse from within the household.

The research concludes that vulnerability is systemic, rooted in policy gaps, weak government monitoring, and the structural conditions of labor migration itself. It cautions against simplistic solutions like deployment bans, which historically have driven migration underground through illegal channels, increasing rather than reducing risk. Instead, it calls for more comprehensive policy reforms, improved pre-departure education, proper HIV counseling protocols, and stronger protections for women migrant workers both at home and abroad.

This exploratory study addresses a largely overlooked dimension of HIV vulnerability among Overseas Filipino Workers (OFWs) — specifically, those who engage in male-to-male sex (MSM). Conducted over ten months using qualitative methods, the study seeks to fill a critical evidence gap in HIV prevention programming by examining the experiences, risks, and vulnerabilities of MSM OFWs both while working abroad and upon returning home.

Data was gathered through five focus group discussions involving 42 male OFWs — including HIV-positive land-based workers, seafarers, and those awaiting deployment — alongside three in-depth case studies and interviews with six civil society key informants. The case studies offer a ground-level view of diverse MSM experiences: a married worker who engaged in same-sex relations abroad, a young worker who survived sexual and physical abuse at his destination, and a self-identified bisexual worker with experience across Southeast and East Asia.

The study finds that while MSM OFWs share many of the same HIV vulnerability factors as migrant workers generally — limited HIV knowledge, inadequate prevention programs, and economic pressures — their specific risks around anal sex, sexual orientation, and gender identity and expression (SOGIE) remain largely unaddressed in existing programs. HIV prevention messaging for OFWs has historically been generic, failing to account for the realities of male-to-male sex, and gender-responsive programming in the migration context has focused almost exclusively on women workers.

The study concludes with four broad areas of recommendation: strengthening HIV education across all phases of migration with explicit SOGIE integration; enhancing HIV services for MSM migrant workers; reforming labor migration and HIV policies to be more inclusive and protective; and expanding the research base on MSM OFWs through dedicated studies and better data disaggregation. Notably, the study also calls for the abolition of mandatory HIV testing and the deportation of HIV-positive migrant workers, advocating instead for rights-based, supportive frameworks.

This action research examines the mental health conditions and stressors experienced by Filipino women migrant domestic workers (MDWs) across different stages of migration: before departure, while working abroad, and upon return. Set against the backdrop of a globally feminizing migration trend, the study responds to growing concern about the well-being of women who comprise a significant and often invisible segment of the world's migrant workforce.

Conducted across four research sites in the Philippines — La Union, Metro Manila, Cebu City, and Davao City — the study surveyed 500 women who had completed at least one overseas domestic work contract, supplemented by focus group discussions, key informant interviews, and case studies. Participants represented diverse destinations including Hong Kong, the Middle East, Singapore, and Europe, and spanned a wide range of domestic work categories.

The findings paint a detailed picture of the structural and personal conditions that shape MDWs' mental health. Most workers lived with their employers and worked between 13 and 24 hours daily, with limited days off and little social protection, particularly those employed in Saudi Arabia and Kuwait. The primary motivations for migration were family-oriented — saving for the future, funding children's education, and alleviating poverty, yet the economic gains came at considerable personal cost.

Stress emerged as pervasive and multi-layered. The greatest sources included workplace demands, family separation, food insecurity, and stressful life events such as the death or illness of a loved one back home. While overseas, the majority of participants reported significant psycho-emotional symptoms including loneliness, sadness, and a persistent desire to cry — symptoms that decreased markedly upon returning to the Philippines, suggesting that the migration environment itself is a primary driver of distress. Despite this, only three percent of respondents had ever consulted a mental health professional, reflecting both the stigma around mental health and the scarcity of accessible services.

The study also highlights the role of cultural coping mechanisms, particularly prayer, solidarity with fellow Filipinos, and maintaining family communication as critical sources of resilience. However, these mechanisms do not always translate effectively into the task-oriented, impersonal cultures of many destination countries.

The research concludes that mental health must be integrated more deliberately into the full migration cycle from pre-departure orientation to on-site support and reintegration programming, with particular attention to the intersecting vulnerabilities of gender, class, and migrant status that shape the experiences of Filipino women domestic workers.

This publication documents the lived experiences of eleven Filipino migrant workers living with HIV/AIDS (four men, six women, and one transgender individual) whose stories collectively illuminate the human dimensions of a public health crisis at the intersection of poverty, labor migration, gender, and stigma. Through richly detailed life narratives spanning pre-departure, life abroad, and return, the publication traces the full arc of vulnerability, diagnosis, and the long, difficult road toward acceptance and advocacy.

The participants came from varied backgrounds but shared common threads: poverty, limited education, early exposure to family dysfunction or abuse, and virtually no knowledge of HIV or sexual and reproductive health before migrating. Economic necessity was the overriding motivation for going abroad, with most workers driven by the desire to support parents, spouses, and children left behind. Pre-departure orientation seminars, where they existed, offered little meaningful health education, leaving workers largely unprepared for the risks they would encounter.

Onsite, the participants faced a range of harsh realities — exploitative working conditions, isolation, overwork, and in several cases, physical and sexual abuse. Gender emerged as a critical axis of vulnerability: women domestic workers were particularly exposed to employer abuse with little legal recourse, while male seafarers operated within cultures of peer pressure that normalized unprotected sex with multiple partners as a marker of masculinity. 

HIV diagnosis, most commonly discovered through mandatory testing at destination countries, was experienced as a devastating rupture. Nearly all participants described intense shock, fear, shame, and suicidal ideation, compounded by the near-total absence of counseling. Deportation often followed swiftly, sometimes within 24 hours, stripping workers of both their livelihood and their dignity. Over time, many participants found pathways toward healing through peer support networks, NGO engagement, and a rekindled sense of spiritual purpose. Several became HIV educators and advocates, channeling their painful experiences into a mission to protect fellow migrant workers from similar fates. Their courage in sharing their stories forms the moral core of the publication.

The publication concluded with an urgent call for the Philippine government and all migration stakeholders to address the systemic failures that leave migrant workers vulnerable from the inadequacy of pre-departure health education and the rights violations inherent in mandatory HIV testing and deportation, to the glaring absence of reintegration programs and sustained treatment support for returning workers living with HIV/AIDS. As migration continues to underpin the Philippine economy, the publication argues, the health and dignity of those who fuel it can no longer be an afterthought.