Qualitative research carried out with undocumented African migrants in New York City revealed that fears of discovery and deportation presented a substantial barrier to seeking out HIV testing services and treatment after diagnosis. Migrants also expressed uncertainty regarding how to go about obtaining health insurance and thought they were not eligible to access health services.
Additionally, stigma from within African migrant communities acted as a barrier to testing, status disclosure and seeking out services. In contrast, health and social service providers played a positive role in facilitating access to services after diagnosis. This research was carried out by Dr Jonathan Ross and colleagues at the Montefiore Medical Center/Albert Einstein College of Medicine in New York and published in the July issue of AIDS Patient Care and STDs.
Immigration from sub-Saharan Africa to the US has more than doubled in recent years. Migrants from this region are disproportionately affected by HIV, with diagnosis rates between three to six times that of the general US population. In New York City African immigrants account for 15% of new HIV diagnoses for people born outside of the US but only make up four percent of the foreign-born population.
African immigrants are less likely to seek out testing services and more likely to initiate care later than other immigrants or nonimmigrants in the US. In the context of more restrictive recent US immigration policies, and the potential for increased marginalisation, this study aimed to better understand the factors specifically affecting undocumented migrants related to HIV testing and linkage to care.