US: Health services now out of reach for many immigrants

New Policy Bars Many Lawfully Present and Undocumented Immigrants from a Broad Range of Federal Health and Social Supports

On July 14, 2025, the U.S. Department of Health and Human Services (HHS) issued a notice of a policy change to update the definition of “federal public benefits” as outlined in the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) to add an additional 13 programs to the 31 programs considered “federal public benefits” that are restricted to individuals with a “qualified” immigration status. The notice further indicates that the updated list of federal benefits is not exhaustive, and additional programs may be added in the future. This change bars many groups of lawfully present immigrants as well as undocumented immigrants from accessing many health care, educational, and other social services and will likely have negative impacts on the health and well-being of immigrant families due to more limited access to services as well as confusion and fear about using services. It also may create new challenges and complexities for service providers. Many implementation questions remain unclear and subject to future guidance, including how verification of immigration status may occur and how the policy will be reconciled with existing conflicting statutory and regulatory requirements, which supersede the guidance. This policy change took effect immediately upon publication of the notice in the federal register on July 14, 2025, although it provides for a 30-day comment period. It also indicates that it will issue further implementation guidance.

Prior Policy under PRWORA

When enacted in 1996, PRWORA established federal requirements that limited eligibility for “federal public benefits” to groups who are “qualified immigrants.” The groups defined as “qualified immigrants” are more limited than groups who are considered lawfully present in the U.S. and exclude undocumented immigrants. Notably, qualified immigrants do not include people with Temporary Protected Status and people with deferred action, including Deferred Action for Childhood Arrivals recipients, among other lawfully present groups (Box 1).

Box 1: Lawfully Present Immigrants by Qualified Status

Qualified Immigrants Other Lawfully Present Immigrants
  • Lawful permanent resident (LPR or green card holder)
  • Refugee
  • Asylee
  • Cuban/Haitian entrant
  • Paroled into the U.S. for at least one year
  • Conditional entrant granted before 1980
  • Granted withholding of deportation
  • Battered noncitizen, spouse, child, or parent
  • Victims of trafficking and their spouse, child, sibling, or parent or individuals with pending application for a victim of trafficking visa
  • Member of a federally recognized Indian tribe or American Indian born in Canada
  • Citizens of the Marshall Islands, Micronesia, and Palau who are living in one of the U.S. states or territories (referred to as Compact of Free Association or COFA migrants)
  • Granted Withholding of Deportation or Withholding of Removal, under the immigration laws or under the Convention against Torture (CAT)
  • Individual with Non-Immigrant Status, includes workers visas, student visas, U-visa, and other visas, and citizens of Micronesia, the Marshall Islands, and Palau
  • Temporary Protected Status (TPS)
  • Deferred Enforced Departure (DED)
  • Deferred Action Status
  • Lawful Temporary Resident
  • Administrative order staying removal issued by the Department of Homeland Security
  • Resident of American Samoa
  • Applicants for certain statuses
  • People with certain statuses who have employment authorization

The PROWRA legislation provided discretion to federal agencies to determine which benefits and programs are “federal public benefits,” while also identifying specific exemptions such as treatment for emergency medical conditions, certain disaster relief, immunizations, and testing and treatment for communicable diseases. It also clarified that non-profit organizations were not required to verify the immigration status of individuals receiving benefits or services. Under policy established in 1998, HHS identified 31 health and social programs considered to be “federal public benefits” restricted to “qualified immigrants,” including major health coverage programs such as Medicaid (excluding emergency Medicaid), Medicare, and the Children’s Health Insurance Program (CHIP).

Changes under the 2025 Policy

The 2025 policy expands the list of programs considered “federal public benefits” by adding 13 additional programs, including Head Start, the health center program, the Title X family planning program, among others (Box 2). The notice further indicates that the list is not exhaustive, and additional programs may be added to in the future.

Box 2: New Programs Considered “Federal Public Benefits” Under the 2025 Policy Change

  • Certified Community Behavioral Health Clinics
  • Community Mental Health Services Block Grant
  • Community Services Block Grant (CSBG)
  • Head Start
  • Health Center Program
  • Health Workforce Programs not otherwise previously covered (including grants, loans, scholarships, payments, and loan repayments)
  • Mental Health and Substance Use Disorder Treatment, Prevention, and Recovery Support Services Programs administered by the Substance Abuse and Mental Health Services Administration
  • Projects for Assistance in Transition from Homelessness Grant Program
  • Substance Use Prevention, Treatment, and Recovery Services Block Grant
  • Title IV-E Educational and Training Voucher Program
  • Title IV-E Kinship Guardianship Assistance Program
  • Title IV-E Prevention Services Program
  • Title X Family Planning Program
  • List is not exhaustive and may be added to in the future

Source: U.S. Department of Health and Human Services (July 2025), “HHS Bans Illegal Aliens from Accessing its Taxpayer-Funded Programs

Implications of the Policy Change

The policy change bars many lawfully present and undocumented immigrants from services that are important for their health and well-being. These programs include certain programs that are particularly important for immigrant families, such as the federal Health Center program, which funds a network of Community Health Centers (CHCs). Community health centers are a national network of over 1,300 safety-net primary care providers located in medically underserved communities and serve all patients regardless of their ability to pay, providing a range of medical, behavioral, and supportive services. Data from the 2023 KFF/LA Times Survey of Immigrants show that three in ten immigrant adults say a CHC is their usual source of care, with this share rising to about four in ten among likely undocumented immigrant adults (42%) and those with limited English proficiency (39%) (Figure 1). The policy also bars immigrants without a “qualified” immigration status from accessing federally funded mental and behavioral health services at a time when many immigrant families are experiencing heightened stress and anxiety due to immigration-related fears and financial uncertainty, as well as from Title X services, which provide comprehensive family planning services to low-income and uninsured individuals.

Beyond health care, the policy also limits access to services that support education, including the Head Start Program. Research shows that adults with higher educational attainment tend to have longer lifespans and be healthier than their counterparts with lower educational attainment. High educational attainment also is associated with better jobs that are more likely to provide employer-sponsored health coverage and higher incomes which, in turn, improve access to health care and resources to support health.

The new policy also will affect service providers who may need to update their policies and procedures to comply with the changes. Under PRWORA, program benefit providers are prohibited from providing “federal public benefits” to people who are not citizens or qualified immigrants and are required to verify that an applicant is a qualified immigrant eligible for services. The notice confirms an existing exemption in the law that non-profit charitable organizations are not required to verify immigration status. However, many implementation questions currently remain unclear and subject to future guidance, including how verification of immigration status may occur. Moreover, the policy does not supersede existing statutory and regulatory requirements. For example, although the notice limits the health center program to “qualified immigrants,” it does not change the underlying statutory requirements for CHCs to serve patients regardlessof immigration status. While federal law supersedes guidance, this conflict creates challenges for CHCs in how they will apply this guidance, and it remains to be seen how enforcement of the guidance will affect CHCs’ ability to provide care. Additionally, as noted, the notice indicates that the list of programs affected by the change is not exhaustive, so additional programs may be added in the future.

The notice estimates that the policy change will result in savings from reduced use of programs by certain immigrants as well as new administrative costs. Savings are estimated to derive from excluding certain immigrants from HHS programs with a corresponding increase in benefits for U.S. citizens and qualified immigrants. There also are estimated to be new administrative costs associated with individuals being required to document their eligibility, for immigration status to be verified, and for changes in program eligibility and operating policies and procedures.

The policy change occurs against a backdrop of other policy changes restricting immigrant access to health and other programs and increased immigration enforcement activity. These changes include new restrictions established under budget reconciliation that limit Medicaid, Medicare, and subsidized Affordable Care Act (ACA) Marketplace coverage to lawful permanent residents, certain Cuban and Haitian entrants, and citizens of the Freely Associated States (COFA migrants). Together, these changes will likely have broad chilling effects on immigrant families, resulting in increased reluctance to access services and programs due to fear and confusion. More limited access to programs and services may lead to negative impacts on their health and well-being. These effects may extend across immigrant families, who often include citizen children—with one in four children in the U.S. living with at least one immigrant parent—and have broader impacts on communities, given immigrants’ role in the workforce.

[Update] US: Idaho immigrants regain HIV treatment access through legal ruling

Federal Judge Restores Access to HIV Treatment for All Immigrants in Idaho

BOISE — Today, a federal judge granted provisional class-action status and extended a temporary restraining order (TRO) in the lawsuit Davids v. Adams. This ruling means access to HIV treatment through the Ryan White HIV/AIDS Program remains available for all immigrants throughout the state, regardless of their immigration status. Before the ruling, the TRO protected access to the program only for the five anonymous patient plaintiffs in the lawsuit.

The judge’s order defines the protected class as “all current or future persons residing in Idaho who have been diagnosed with HIV and who would qualify for federally funded services through the Ryan White Program unless required to verify [their immigration status] for those benefits.”

A decision on the preliminary injunction is expected in the coming weeks.

Davids v. Adams was filed on June 26, 2025 by the American Civil Liberties Union (ACLU) of Idaho, the National Immigration Law Center (NILC), and private law firms Nixon Peabody LLP and Ramirez-Smith Law in response to House Bill 135.

#####

The ACLU of Idaho is a non-partisan, non-profit organization dedicated to the preservation and enhancement of civil liberties and civil rights. The ACLU of Idaho strives to advance civil liberties and civil rights through activities that include litigation, education, and lobbying. Learn more at acluidaho.org.

Established in 1979, the National Immigration Law Center (NILC) is one of the leading organizations in the U.S. exclusively dedicated to defending and advancing the rights of low-income immigrants. At NILC, we believe that all people who live in the U.S. should have the opportunity to achieve our full potential. Over the years, we’ve been at the forefront of many of the country’s most pressing immigration issues, and we play a major leadership role in addressing the real-life impact of policies that affect the ability of all of us to prosper and thrive.

Nixon Peabody LLP is an American Lawyer top-100 law firm in the United States and has 15 offices worldwide. Our firm delivers exceptional service to our clients and our communities by combining high performance, entrepreneurial spirit, deep engagement, and an unwavering commitment to a culture of collaboration and humanity.

Ramirez-Smith Law is a leading immigration law firm dedicated to defending the rights of immigrants, asylum seekers, and underserved communities across the United States. With a proven commitment to justice, the firm advocates for individuals facing systemic barriers within the immigration system and beyond. Headquartered in Nampa, Idaho, Ramirez-Smith Law provides compassionate, high-impact legal representation in removal defense, asylum, family-based immigration, humanitarian relief, employment-based immigration, and federal litigation—including complex litigation challenging unlawful government practices and policies. Our firm is proud to stand at the intersection of legal advocacy and social justice, using the law as a tool to protect human dignity and hold institutions accountable. We believe every client deserves to be heard, and every community deserves to be defended. For more information, visit www.nrsdt.com or contact us at 208-461-1883.

Global study reveals 50 countries still enforce HIV-related travel restrictions

A new global study presented this week at the 13th IAS Conference on HIV Science in Kigali (IAS 2025) has revealed that 50 countries around the world continue to enforce HIV-related travel and residence restrictions, in clear violation of international human rights principles.

The data, shared by the HIV Justice Network through its new platform Positive Destinations, highlights the persistence of discriminatory laws and policies that prevent people living with HIV from freely travelling, working, studying, or settling in many parts of the world.

Despite progress – 83 countries now have no HIV-specific travel restrictions, and many others have adopted more inclusive approaches – 17 countries still impose severe measures such as outright entry bans, mandatory testing, and deportation. These include Bhutan, Brunei, Egypt, Iran, Kuwait, Malaysia, Russia, and the United Arab Emirates. Migrants and students are often disproportionately affected, with some unaware of the rules until after testing or disclosure, resulting in forced returns, loss of income, and separation from families.

Another 33 countries – including Australia, Canada, Kazakhstan, the Philippines, Saudi Arabia, and Singapore – have partial restrictions. These include requirements for HIV testing in visa applications, discretionary decisions based on perceived healthcare costs, and reduced access to essential services. Although these policies may appear neutral on the surface, they continue to disadvantage people living with HIV.

“These restrictions are rooted in outdated public health thinking and perpetuate stigma,” said Edwin J Bernard, HIV Justice Network’s Executive Director. “They obstruct access to healthcare, education, and family life, especially for migrants and refugees.”

   Click on the image to download the poster

In 2024, Positive Destinations documented several cases of deportation based solely on HIV status: Kuwait deported over 100 people, Russia’s Dagestan region deported nine, and Libya deported two. Such practices are increasingly being challenged by legal action. In Canada, for example, a court case led by the HIV Legal Network contests the “excessive demand” clause of immigration law, arguing it violates the country’s Charter of Rights and Freedoms.

However, policy reform has been uneven. Australia raised its health cost threshold for visa eligibility, slightly easing access to temporary stays, but permanent residency remains elusive for many people with HIV. A recent case saw an Italian teacher denied residency due solely to his HIV-positive status.

The study also underscores how HIV-related migration barriers often intersect with other forms of criminalisation and discrimination. In Uzbekistan and Russia, HIV criminalisation laws are paired with mandatory HIV testing for migrants. In the U.S., HIV-positive and LGBTQ+ asylum seekers continue to face mistreatment in detention centres. And in a tragic case in Turkey, a Syrian trans woman was reportedly deported after her HIV status was disclosed and later killed upon return.

The authors of the study call for urgent action: “Eliminating these harmful policies is essential to ending AIDS, achieving universal health coverage, and upholding the dignity and rights of people living with HIV everywhere,” said Bernard.

Positive Destinations, which hosts the updated Global Database on HIV-Specific Travel and Residence Restrictions, is available at www.positivedestinations.info


EP0623 Addressing HIV-related travel restrictions: Progress and challenges in eliminating discriminatory policies by Edwin J Bernard, Sylvie Beaumont, Elliot Hatt, and Sofía Várguez was presented at IAS2025 by Brent Allan at the 13th IAS Conference on HIV Science, Kigali, Rwanda.

South Africa: Overview of healthcare access for undocumented migrants in South Africa

Healthcare Access for Undocumented Migrants in South Africa: What You Need to Know

Access to healthcare is a fundamental human right enshrined in South Africa’s Constitution. However, the reality for undocumented migrants seeking medical care in the country remains complex and often fraught with challenges. This article provides a clear, factual overview of healthcare access for undocumented migrants in South Africa. It highlights legal rights, barriers faced, and ongoing debates.

Section 27(1) of the South African Constitution guarantees everyone the right to access healthcare services, including reproductive healthcare. This right extends to all individuals within the country’s borders, regardless of nationality or legal status. Specifically, Section 27(3) mandates that emergency medical treatment must not be denied to anyone. This underscoring the country’s commitment to human dignity and health rights.

The National Health Act further supports this by stating that primary healthcare services are available to all people, irrespective of immigration status. Refugees, asylum seekers (with or without permits), permanent residents, and even undocumented migrants are entitled to emergency healthcare services. However, at the very least.

Categories of Migrants and Their Healthcare Rights

  • Refugees and Asylum Seekers: Recognised refugees and those awaiting status have the same rights to healthcare as South African citizens. This includes access to clinics, maternal and child healthcare, HIV and TB treatment, and mental health support.
  • Permanent and Temporary Residents: These groups also have access to public healthcare. Temporary residents are often required to pay fees based on income.
  • Undocumented Migrants: While lacking legal documentation, undocumented migrants retain the constitutional right to emergency medical care. Access to non-emergency services is more limited and often subject to administrative discretion, but denying emergency care is unlawful.

Barriers and Challenges in Practice

Despite clear legal protections, undocumented migrants frequently face obstacles when seeking healthcare:

  • Medical Xenophobia: Many migrants report discrimination and refusal of services by healthcare providers. This is due to their foreign status or lack of documentation. This practice undermines public health and violates constitutional rights.
  • Fear of Deportation: Undocumented migrants may avoid seeking care due to fears. They fear that healthcare providers will report them to immigration authorities, as required by the Immigration Act.
  • Cost and Accessibility: Some migrants are charged fees or denied free services, despite legal provisions. Language barriers and lack of information further complicate access.
  • Policy Conflicts: The National Health Insurance Bill and Immigration Act introduce conflicting requirements. These sometimes restrict undocumented migrants’ access to healthcare. This contrasts with constitutional guarantees.

Access For All?

The South African Constitution guarantees healthcare access for undocumented migrants, especially in emergencies. Yet, challenges such as discrimination, fear, and conflicting policies persist. Continued legal advocacy, public education, and policy reform are essential. They are necessary to ensure that all individuals, regardless of documentation status, can access the healthcare they need.

US: Federal Judge blocks Idaho’s Immigration Law from targeting HIV program

Federal judge temporarily protects HIV program from new Idaho immigration law

A federal judge has temporarily blocked Idaho from applying a new state law meant to prevent unauthorized immigrants from accessing publicly funded assistance to one health program.

U.S. District Judge Amanda Brailsford on Monday issued a temporary restraining order blocking the Idaho Department of Health and Welfare from requiring citizenship status reviews for a federally funded HIV treatment program.

The decision blocks the law’s application to this program until a court hearing in two weeks about whether the court should block the law for longer.

The new law, House Bill 135, took effect Tuesday. It cuts the few publicly funded services that unauthorized immigrants can receive in the state.

The judge’s ruling came days after ACLU of Idaho sued over the new law, alleging the law is unconstitutional by violating equal protection, conflicts with federal laws and even denies federal funds to people eligible under federal law.

US: Lawsuit filed to block Idaho law restricting access to HIV treatment for Immigrants

BOISE — On Thursday, June 26, 2025, the American Civil Liberties Union (ACLU) of Idaho, the National Immigration Law Center (NILC), and private law firms Nixon Peabody LLP and Ramirez-Smith Law filed a lawsuit against the state of Idaho to stop enforcement of House Bill 135, which is set to go into effect July 1, 2025.

House Bill 135 was passed during the 2025 legislative session to impose new immigration status verification requirements on programs that are not restricted under federal laws, including access to food pantries and soup kitchens, prenatal and postnatal care, vaccines and life-saving medications to treat communicable diseases such as HIV, among others. Prior to the new law, these benefits were available to Idaho residents without having to verify immigration status.

The lawsuit, Davids v. Adams, is seeking a temporary restraining order (TRO) preventing the state from barring access to federally funded HIV medication for immigrants who cannot verify their lawful presence. The TRO is necessary because the Idaho Department of Health and Welfare, which administers the federal funding, has determined that on and after July 1, 2025, recipients of this funding must meet the lawful presence criteria outlined in the law. Without access to this medication, many immigrant residents will suffer a variety of serious health issues, including, potentially, death.

The plaintiffs in Davids v. Adams are Dr. Abby Davids, a doctor who treats patients living with HIV, and five immigrant Idahoans living with HIV.

The lawsuit argues that House Bill 135 attempts to circumvent federal law, which allows access to certain federally funded benefits programs, including the federal program that provides HIV medication (known as the Ryan White HIV/AIDS Program), without regard to citizenship or immigration status.

“Nobody benefits from barring access to life-saving HIV medication,” said Dr. Abby Davids, practitioner at Full Circle Health. “Both for individual patients and for the health of our community as a whole, all people living with HIV need to be able to access consistent care and treatment. Infections like HIV do not infect people based on their immigration status, and treatment should not be limited by legal status, either. I am genuinely afraid for my patients who currently take medication for HIV; without it, their lives will be in jeopardy.”

“HB 135 is designed to dehumanize our immigrant neighbors by denying them the basic necessities of life — medicine, food, and shelter. It subverts constitutional rights and interferes with federal regulation of immigration,” said Paul Carlos Southwick, ACLU of Idaho Legal Director. “Along with HB 83, this is the second unconstitutional bill we’ve sued to stop this year. It is part of the state’s campaign to displace immigrant residents, which will separate families and inflict lasting trauma. The state’s actions are legally indefensible and morally wrong.”

“This inhumane bill unconstitutionally seeks to block full public access to essential health care, including life-saving HIV care and treatment, and threatens the health and wellbeing of Idahoans across the state,” said Joanna Cuevas Ingram, senior staff attorney at the National Immigration Law Center. “Federal law has expressly exempted the Ryan White HIV AIDS Program, among others, from citizenship and immigration status requirements, ensuring that vulnerable individuals are not denied life-saving care due to their immigration status and to meet nationwide public health goals in reducing HIV transmission. H.B. 135 cannot subvert federal law or the will of Congress. A restraining order and injunction are necessary.”

“The message to immigrant and Latine communities is clear: No matter what kind of person you are, no matter how meaningfully you contribute to Idaho, no matter how hard you struggle to support your family, you are not wanted here,” said Ruby Mendez-Mota, ACLU of Idaho Interim Advocacy Director. “This law isn’t about safety or security, it’s not about limited resources; it’s about making an already vulnerable part of Idaho’s hardworking community feel like they aren’t good enough to be treated with dignity. This fight is not over.”

 

France: Young man with HIV detained without treatment faces expulsion, despite years of residency

For two months, the 23-year-old man has been detained at the CRA in Cornebarrieu (Haute-Garonne), where he has not received his HIV treatment. The associations are asking for a reassessment of his file. Politis was able to reach him.

His voice is weakened, almost inaudible. He seems exhausted. Joes arrived in France at the age of 11, then was adopted by his grandmother. He has 22 today. All his life is here. He went to college and then high school in the North, did two years of art school and then multiplied odd jobs, in catering and sales. In the meantime, he learns that he has HIV. He should have filed his birth certificate at the age of 18 to be officially regularized but he forgot and then covid-19 arrived and the administrations remained closed. He receives an OQTF (obligation to leave French territory).

“I didn’t really take it seriously. Instead of challenging her, I preferred to work, keep a low profile, thinking that things would work out, “says the young man. “If my birth certificate had been filed, they could have registered me in the civil registry and I would be French. From there, everything degrades. The man, detained at the administrative detention center (CRA) in Cornebarrieu, near Toulouse, was to be expelled by plane on Monday, June 23 to his country of origin in the Democratic Republic of Congo (DRC). A country he doesn’t know.

International aid stopped

To avoid being sent back, Cimade advised him to apply for asylum as a matter of urgency to the French Office for the Protection of Refugees and Stateless Persons (Ofpra). The aim was to re-evaluate his case. A new element was added, as Julie Aufaure, in charge of detention at Cimade, explains: “Care for people with HIV in the DRC is a little better than it used to be. But doubts have returned with the decision by the United States to withdraw its international aid, particularly on health issues”.

More and more foreign nationals living with HIV are being refused entry to the country.It was the Pepfar programme (President’s Emergency Plan for AIDS Relief), which financed a very large part of access to treatment in developing countries – particularly the DRC – with almost 54%. However, “this decision is not yet measurable, but there are major concerns on the ground. And the professionals in the field know that this is going to become a real problem very, very quickly”, continues Julie Aufaure.

This concern is shared by Adrien Cornec, head of mission for the AIDS charity Aides. He explains that France has had a right to residence on medical grounds since 1990. “But for some years now, the authorities have been calling it into question. We’re seeing more and more foreign nationals living with HIV being refused residence. In particular, people who have been refused residency following applications for renewal. In other words, people who have been here for several years.

He adds: “From one day to the next, these people find themselves in an irregular situation, obliged to leave French territory and go to a country where they haven’t lived for long and are not guaranteed access to care.

“We were rejected everywhere”

Julie Aufaure admits that Joes’ situation is complicated. “We’ve been rejected everywhere, unfortunately, because the prefectural authorities and the European Court of Human Rights base their decision on the decision of the Office’s doctor, who says that the treatment exists.

Joes, for his part, ‘hopes from the bottom of his heart’ for a positive response from Ofpra. Especially as he has been subjected to mockery in the detention centre since his arrival on 6 April. Medical confidentiality has been broken. He has been subjected to ‘moral and physical harassment’ by both ‘officers and detainees’. According to him, the detention centre officers spread the information to everyone in the centre. Some felt sorry for them, others laughed. His fellow detainee added that this stigmatisation was recurrent.

Apart from his roommate, with whom he talks, the young man has withdrawn into himself. “It’s still really a wolf’s world here. I prefer to be on my own. People can fight over a piece of bread or a cigarette. It’s a disgrace”, says Joes.

Worse still, he says he has never received his treatment since his arrest. When he arrived, he had a blood test and a check-up a fortnight later. But since then, radio silence. ‘They nearly put me on the plane, in this state, without me having had the treatment…’. As he is HIV-positive, it is essential that he takes his medication every day. The absence of treatment can have serious effects on his health, such as a drop in his immunity, making him extremely vulnerable to other illnesses. According to the Cimade employee, this is a case that ‘borders on the legal’, but she assures us that the procedure is long and going well.

Action still possible

If the asylum application is rejected or deemed inadmissible, Julie Aufaure plans to lodge an appeal with the national court for the right of asylum (CNDA) and ask the administrative court to suspend the deportation until the court has made its decision, but ‘that’s pretty much the last option for him’, she says.

Adrien Cornec says he is very concerned about ‘these refusals of residence and their accommodations’. Aides and the other associations are calling for the application of the decree of 5 January 2017, which states that ‘in all developing countries, it is therefore not yet possible to consider that HIV-positive people can have access to antiretroviral treatment or to the medical care required for all carriers of an HIV infection as soon as they are diagnosed’.

The Aides representative alerted Senator Anne Souyris. The ecologist sent letters to the prefects of the Pyrenees and Haute-Garonne, and also directly to the Minister of the Interior, Bruno Retailleau. “We don’t expel people who can’t be treated in their own country. There’s a political issue behind it”, she told Politis.

According to the senator, this is a real ‘death sentence’ for Joes, given that international funding has stopped. The senator goes further than the individual case and calls for all the people who could be affected to be automated: “There should be a circular (…). This should also be a textbook case for managing this situation.

US: LGBTQ migrants with HIV face systemic failures and neglect in U.S. custody

Queer, Undocumented and HIV Positive

The current political climate is making immigrants feel unwelcome in America.

Immigration continues to be a hot-button issue in the United States. Whether they are seeking asylum from a violent region of the world or coming here for a better life for your family, immigrants (specifically non-white immigrants) face a host of challenges.

LGBTQ immigrants living with HIV, face downright Sisyphean challenges. Undocumented people can’t access any health services without paying out of pocket, which can be monumentally expensive. Even if they are welcomed at a clinic, it’s possible that no one there will be able to speak their language or understand their culture. And currently, there’s the added risk that Immigration and Customs Enforcement (ICE) officers may be staking out the place.

If an LGBTQ person and/or a person living with HIV is taken to jail, it’s very likely that they’ll suffer abuse. A 2024 study published by Immigration Equality, the National Immigrant Justice Center (NIJC) and Human Rights First reports that ICE and Customs and Border Patrol (CBP) agents at detention centers regularly abuse queer people and people living with HIV who are in their custody.

The study reported that one third of the participants experienced sexual, physical and mental abuse and sexual harassment, while nearly all reported incidents of verbal abuse and threats of violence. A quarter of the participants in the study reported being separated from loved ones, whether a partner, a spouse or sibling, and half of those in the study were kept in solitary confinement. Many had to scramble to find legal representation and sometimes were denied access to their attorney.

Most detainees also stated that they were given inadequate medical care or denied care altogether. Of the detainees living with HIV, most reported neglect or denial of HIV care. Nearly half reported suffering mental health problems, including panic attacks, flashbacks and self-harm. More than half stated that their HIV status, gender identity, sexual orientation, medical or other confidential information was disclosed without their consent.

More disturbing is the fact that many of those immigrants came here seeking amnesty, fleeing violence or other harsh ramifications in their homeland for simply being queer or because they’re living with HIV.

People living with HIV who are trying to emigrate to the United States cannot be denied entry based on their HIV status. (In 2010, President Obama lifted the “HIV ban” that had been in effect for 22 years.) Also, no one can be denied entry solely based on their sexual or gender identity.

As U.S. HIV and LGBTQ communities strive to keep healthy and safe, they must also remember those who need extra protection and care. Our arms must be big enough to hold fast to those who are extra vulnerable.

US: Doctors report dangerous delays in care among migrants fearing deportation

Since President Trump announced plans for mass deportations and rescinded protections for hospitals and clinics, health care facilities have seen a jump in no-shows.

A man lay on a New York City sidewalk with a gun shot wound, clutching his side.

Emily Borghard, a social worker who hands out supplies to the homeless through her nonprofit, found him and pulled out her phone, preparing to dial 911. But the man begged her not to make the call, she said.

“No, no, no,” he said, telling her in Spanish that he would be deported.

Ms. Borghard tried to explain that federal law required hospitals to treat him, regardless of his immigration status, but he was terrified.

“He said, ‘If I go to the emergency department, that will put me on their radar,’” she recalled in an interview recounting the incident.

Across the country, doctors, nurses and social workers are increasingly concerned that people with serious medical conditions, including injuries, chronic illnesses and high-risk pregnancies, are forgoing medical care out of fear of being apprehended by immigration officials. Since the Trump administration announced plans for mass deportations and rescinded a Biden-era policy that protected spaces like hospitals, medical clinics and churches from immigration enforcement, doctors said they have seen sharp increases in patient anxiety and appointment no-show rates.

If the trend continues, health care officials say, the list of consequences could be long: Infectious diseases circulating unnecessarily; worsening health care costs because of untreated chronic illnesses; and dangerous birth complications for women who wait too long to seek help, among others.

In a survey conducted by KFF, a health policy research organization, 31 percent of immigrants said that worries about immigration status — their own or that of a family member — were negatively affecting their health. About 20 percent of all immigrants surveyed said they were struggling with their eating and sleeping; 31 percent reported worsened stress and anxiety.

A White House spokesman did not respond to messages seeking comment. When the administration announced that it was ending protections at hospitals on Jan. 21, a statement from the Department of Homeland Security said the new policy was intended “to enforce our immigration laws and catch criminal aliens.”

Research has shown that immigration crackdowns are linked with poorer birth outcomes and mental health status, lapses in care, and fewer people accessing the types of public programs that reduce illness and poverty overall.

“We’re really creating not just very serious health risks, but economic risks in the long run for our country,” said Julie Linton, a pediatrician and member of the committee on federal government affairs for the American Academy of Pediatrics. “These policies are creating very real fear and uncertainty for people and have a tremendous impact on their ability to function on a day-to-day level.”

Many immigrant communities suffer from high rates of chronic conditions such as high blood pressure and diabetes, which, if left untreated, can lead to heart attack, stroke and other grave complications.

That is why doctors worry about patients like Maria, a 47-year-old woman with pre-diabetes, who has been going to the same primary care clinic ever since she arrived in the United States from El Salvador 20 years ago. Even during the first Trump administration’s crackdown on immigration, she continued to seek medical care. But when the protections around hospitals and clinics were rescinded earlier this year, Maria canceled her appointment to have her blood sugar checked, a routine and crucial element of diabetes prevention in patients like her.

“We’re very scared of being in the clinic and having ICE arrive while waiting to be called,” she said in Spanish, referring to U.S. Immigration and Customs Enforcement.

Maria, who asked that her last name not be published, said that she is in a state of “constant anguish.” She said she avoids leaving the house and is working on a plan for the care of her children, who are American citizens, in case she and her husband are deported.

One of their daughters, who is 15, is being treated for fatty liver disease and the other, 11, needs therapy for a developmental condition. Their older daughter has another doctor’s appointment in June. Maria and her husband don’t want to interrupt her care, but they are worried about taking her there themselves. “It’s very complicated,” Maria said. “I can put myself at risk for my children. But if it’s for my own health, I prefer to let it go.”

The consequences of abandoning regular medical care can turn serious quickly, however. Jim Mangia, president of St. John’s Community Health Network in Los Angeles, described one patient with diabetes who stopped showing up for a weekly diabetes education class. When a clinic staff member called the woman, they discovered she was afraid to even go to the grocery store, and had been subsisting for days on tortillas and coffee, he said.

“Thank God we reached her and she came in,” said Mr. Mangia, whose network serves an estimated 25,000 undocumented patients across more than 20 locations. Tests at the clinic showed that her blood sugar had become dangerously high.

“That’s what we’re going to see more and more of,” Mr. Mangia said. “It kind of breaks my heart to talk about it.”

For doctors working in urgent care settings, a drop-off in immigrants has become apparent through some unusual metrics. For example, Dr. Amy Zeidan, an emergency room physician in Atlanta, said that requests for Spanish-language interpretation in her hospital’s emergency department had fallen more than 60 percent from January to February.

Theresa Cheng, an emergency room physician at Zuckerberg San Francisco General Hospital and Trauma Center, said one of her residents had seen an immigrant patient who had suffered multiple facial fractures from an assault, but had not sought care for more than two weeks. “There is tremendous fear,” Dr. Cheng said.

In late January, Dr. Cheng said, she saw a patient who arrived with severely untreated diabetes. The patient, an undocumented woman, said she had waited to receive help because she was scared. She died that day.

Dr. Carolina Miranda, a family physician in the Bronx, spoke of a patient who had been granted asylum but, fearful of ICE, had failed to show up for a doctor’s appointment about a possible brain tumor.

Similar delays or cancellations are arising among pregnant women and new mothers, according to obstetrician-gynecologists around the country. Dr. Caitlin Bernard, an obstetrician in Indiana, said a patient had skipped her postpartum visit, explaining that she would no longer be leaving her house. On an obstetrics floor in a San Diego hospital, multiple staff members said they had seen an overnight drop-off following the inauguration in the number of immigrant women coming in with acute issues during their pregnancies.

“Obviously those women still exist,” said one doctor, who asked not to be identified because her employer forbade her from speaking publicly on the matter. “I fear it’s going to increase maternal mortality over time.”

Many of the children of immigrant parents who have skipped appointments or left medications unfilled are American citizens. But in mixed-status families, parents who are at risk of deportation are often unwilling to take the risk of going to the clinic or pharmacy.

A pediatrician at a health center that cares for underserved populations on the central coast of California reported a 30 percent increase in no-shows for pediatric appointments. Many of those who do bring their children, and are referred elsewhere for specialty care, such as speech therapy, or an autism evaluation, refuse, saying they are too frightened, said the pediatrician, who asked to be unidentified because he wasn’t authorized to speak publicly.

Dr. Tania Caballero, a pediatrician at Johns Hopkins who sees patients at a health center for underserved groups called Baltimore Medical System, said she had encountered parents who had not wanted to go with their babies to the emergency room out of fear, and parents of children with chronic conditions like cerebral palsy, asthma, and Type 1 diabetes who had told her they have stopped getting vital care.

“I tell patients, ‘I can’t control what happens outside of my space, and I can’t control if somebody comes into my space, But you know me. I have the tools, and I want to help you navigate this journey and do it together,’” she said.

Some parents of children in other dire situations — such as those receiving cancer treatment — are hoping that their child’s condition might actually protect them. Some have asked pediatricians for letters explaining their child’s medical requirements, in hopes that immigration officials who detain them might be convinced that the child needs to stay in the United States to survive.

Dr. Lisa Gwynn, a pediatrician in South Florida who serves families from across the Caribbean and South America, said that her plummeting patient attendance rate is particularly worrisome because patients are missing out on childhood vaccines necessary for preventing diseases like measles, pneumonia and whooping cough.

Dr. Gwynn also worries that without coming to see her, children who have experienced severe trauma before coming to the United States aren’t being connected to social workers or psychologists who can help.

“Imagine your children living in a home where everyone’s scared, and they’ve come to this country to not feel scared anymore,” she said. “We know that stress does not fare well for health. Period. Kids don’t perform as well in school, they have mental health issues, depression, anxiety.”

Some medical facilities have said they will comply with immigration officials. NYU Langone, in New York City, sent a memo to employees warning them not to try to protect illegal migrants. But many other health centers and organizations are finding ways to take a stand, telling staff to display “Know Your Rights” information on the walls and to never record their immigration status in a patient’s medical records.”

Last week, the New England Journal of Medicine published an article by two doctors and a lawyer detailing how physicians can continue to provide health care and lawfully push back in the face of some ICE requests.

The St. John’s clinic network in Los Angeles recently launched an ambitious home visitation program in which a doctor, nurse and medical assistant visit patients where they live to perform exams and deliver medications. They aim to inform all 25,000 of their undocumented patients of this option.

In the New York area, a hospital association suggested designating a “hospital liaison” who can be paged to quickly usher an agent into a private office, and then ask to see a signed warrant, which would then be reviewed by in-house counsel.

At the emergency room of University Hospital, a safety net facility in Newark, staff members hand out cards, in Spanish and other languages, reminding patients of their rights. “You have the right to refuse consent for immigration or the police to search yourself, your car or your home,” the cards state.

But even there, the fear is palpable. Annalee M. Baker, an emergency physician, said she had seen a young woman who said her partner had beaten her until she was unconscious. Covered in welts and bruises, she had waited hours to come in. The reason given: she was terrified that her partner would be deported.

Dr. Baker also treated a minor who had been stabbed; she had needed his parents’ consent to treat him, but the boy had been skittish about providing any details about them, out of fear they might be caught in the immigration dragnet.

Still, it is the people who never come in at all that haunt Dr. Baker the most.

“The tragic message to these people is: Be a shadow and hope that you do not die.”

Sarah Kliff contributed reporting.

Emily Baumgaertner Nunn is a national health reporter for The Times, focusing on public health issues that primarily affect vulnerable communities.

Nina Agrawal is a Times health reporter.

Jessica Silver-Greenberg is a Times investigative reporter writing about big business with a focus on health care. She has been a reporter for more than a decade.

UAE: New Dubai regulations define traveler obligations and health responsibilities

Dubai’s new public health law could affect your next trip — here’s how

His Highness Sheikh Mohammed bin Rashid Al Maktoum, Vice President and Prime Minister of the UAE, has issued a new public health law in Dubai.

Law No. (5) of 2025 on Public Health in Dubai seeks to minimise health risks by stopping the spread of illnesses and putting restrictions on travel for those with confirmed communicable diseases.

Set to come into force 90 days after it is published in the Official Gazette, the new law supersedes any previous legislation that may conflict with its provisions.

The new law states that any travellers must adhere to official health protocols, provide requested information at Dubai’s entry points and report any suspected or confirmed communicable diseases.

Anyone who is infected or suspected of having a communicable disease must avoid contact that could spread their illness. The new law states that you must refrain from travelling or moving, except to healthcare facilities, without the approval of the Dubai Health Authority.

If you are travelling while ill, then you must observe hygiene measures such as wearing masks and maintaining physical distancing in line with approved guidelines.

The law prohibits concealing infections or spreading them, whether intentionally or unintentionally, and mandates individuals to comply with measures to prevent the spread of disease, following guidelines issued by relevant authorities and healthcare providers.

The new public health law has established a comprehensive framework to promote public health and safeguard community and environmental well-being. It outlines a focus on disease prevention, healthcare, food and product safety and sustainable efforts to improve overall quality of life.

It aims to minimise any health risks affecting individuals and communities in Dubai through precautionary measures and evidence-based practices that align with both local and international health regulations.

The new law promotes greater coordination and collaboration at all levels to strengthen preparedness and response to deal with any public health challenges in the emirate.

It also aims to increase public awareness of health risks and prevention methods by fostering a sustainable environment that attracts investment.

The new public health law has also formally defined the roles and responsibilities of relevant authorities in managing communicable diseases.

These authorities include local government entities tasked with overseeing public health in Dubai, such as Dubai Health Authority, Dubai Municipality, the Dubai Environment and Climate Change Authority, the Dubai Academic Health Corporation and the Dubai Corporation for Ambulance Services.

The law has also outlined the responsibilities of relevant authorities in food safety, specified obligations for food-related establishments and set out some rules for consumer product activities.

It has detailed responsibilities in areas such as built environmental health, labour accommodations, pest control and the Dubai Health Authority‘s role in managing health risks, emergencies and crises.