Migrants, stigma, and the ongoing HIV epidemic, explained

Written by the Gilead Sciences Team

A man is diagnosed with HIV in November, yet does not start treatment until February out of fear of deportation. Miles away, another man is rejected by his family for identifying as LGBTQI+ and must migrate away from his home for embracing his true self.

These stories are all too common, reflecting deep-rooted stigmas that affect migrants and displaced people across the globe. Migrants leave their countries to seek asylum from conflict, persecution, or economic challenges, only to be faced with a different set of significant obstacles, like language barriers, lack of resources and racial and socioeconomic discrimination – all of which are deterrents to accessing quality healthcare. Imagine trying to access healthcare in a system that wasn’t designed for you, and in fact may even be designed to exclude you?

In many places around the world, including in the US, migrant communities face unsafe conditions and unreliable healthcare, exacerbating the impacts of the HIV epidemic on them and underlining the urgency to take action. A daunting 46% of new HIV diagnoses globally were among migrants in 2021, according to data from the European Centers for Disease Control.

Through fearless determination to address unmet needs across the HIV care continuum, and the resulting health inequities, two frontline advocates stepped up to take action in their communities.

Born and raised in Kenya, Denis Onyango has seen firsthand the importance of access to equitable HIV care. Onyango grew up with a close relationship to his brother – a brilliant engineer and a man he called his hero. Onyango stepped into the unexpected role of caretaker when his brother was diagnosed with AIDS, and cared for him until he passed from complications of the disease. Following his brother’s passing, which he refers to as a turning point in his life, Onyango moved to the UK and joined the HIV advocacy space, where he learned of the many HIV treatment options that his family did not have access to in Kenya.

Now, as Director of Programs at the Africa Advocacy Foundation (AAF), a Gilead grant recipient, Onyango oversees initiatives supporting migrants impacted by HIV, ensuring access to HIV testing, prevention, and treatment resources for undocumented migrant communities who typically face legal, governmental, and systemic barriers. To continue dismantling stigmas, particularly around migrants from Africa and the Middle East, Onyango and his team also prioritize providing culturally competent HIV education – focusing on the dangers of stigmatizing language and discriminatory guidelines that are preventing migrants from receiving care. Through these efforts, AAF maintains a person-centric approach in creating a safe, secure environment for migrants to access the care they need.

As a Pakistani-Dutch, Muslim trans woman who was born to immigrant parents, Isjed Hussain has a wealth of lived experience surrounding the stigmas and barriers faced by migrant communities. Even from a young age, Hussain remembers the feelings of being misunderstood by White society – living in a culture and in a family with expectations of her identity that differed from her reality. As a result, Hussain was determined to help others who faced similar challenges – particularly LGBTQI+ migrants.

In addition to the barriers faced by asylum seekers in general, LGBTQI+ migrants are unfortunately impacted by additional challenges, including a lack of gender-affirming care options and holistic health resources like mental healthcare, and even anti-LGBTQI+ discrimination or persecution. In 2017, Hussain started the Prisma Group Foundation as a safe space for bicultural LGBTQI+ migrants and refugees in the Netherlands, with the goals of continuing important discussions on the intersectionality of identity and empowering those seeking asylum. As part of these goals, the Foundation provides financial support and even travel resources for migrants to receive necessary HIV care, as well as guidance for those formally seeking asylum.

There has been inspiring, substantial and unwavering progress made in addressing the impact of HIV on migrant communities, but there is more work to be done. With the current political climate and continued challenges for migrants and displaced people, we must come together as a community to break down HIV stigmas and help enable universal access to services across the full HIV care continuum. From igniting conversations about available HIV prevention and treatment options to directly addressing the misconceptions and acknowledging the realities of migration, together we can help end the HIV epidemic for everyone, everywhere.

To hear more on this topic, listen to the full podcast episode featuring Denis Onyango and Isjed Hussain here, also available below, as part of Gilead Sciences’ Zero Hour™ series, a global podcast for open conversations with leading experts working to address HIV and advance health equity for all. Zero Hour™ is available on all major podcast platforms and YouTube.

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