Canada: Montreal’s only anglophone HIV/AIDS care centre helps migrants living with HIV navigate their integration into the province

A path to new beginnings: migrants with HIV

Montreal’s only anglophone HIV/AIDS care centre supports newcomers beyond healthcare.

Colombian immigrant Ferney Mendoza sits in a warmly lit room watching a PowerPoint presentation at Montreal’s only anglophone and allophone HIV/AIDS support centre.

He is joined by four other newcomers on a ring of couches, with a spread of snacks in the centre.

The workshop is part of a three-month program designed to help migrants living with HIV navigate their integration into the province.

On the screen, Quebec is highlighted on a map of Canada and labelled with a bold “14 per cent”—the province’s minimum tax rate. Today’s topic: how to file taxes.

For many newcomers with HIV, immigrating to a new country isn’t just about accessing medication. For Mendoza, workshops like this one—focused on understanding tax rules in Canada—helped him stabilize his income and better support his three children.

The aptly named “New Horizons” workshop series is hosted by AIDS Community Care Montreal (ACCM). The five-year-old program was initially geared towards Spanish-speaking immigrants with HIV, but has expanded in recent years to meet the changes in Canada’s immigrant population.

Organizers at ACCM say that supporting successful integration has become increasingly important as more newcomers are being diagnosed with HIV.

The latest federal data reveals that over 2,000 migrants tested positive for HIV in 2022, an increase of close to 145 per cent within a single year.

In Quebec, the number of new recorded HIV cases in 2022 grew by over 75 per cent compared to the previous year. According to the Institut national de santé publique du Québec, the rise in cases is linkedto an overall increase in the number of migrants arriving in the province.

More than just healthcare

Mendoza came to Montreal in 2021 with his family after fleeing Colombia. Their safety was threatened due to discrimination against their transgender son and Mendoza’s own fears of being persecuted for living with HIV.

Migrants with HIV, he said, are at the intersection of multiple obstacles. Navigating an entirely new healthcare system is only one part of the challenge—having access to support for social and cultural integration is just as important.

“Human beings are dimensions: emotions, family, work and money,” he said. “[ACCM] really took me as a whole individual.”

Many migrants with HIV receive their diagnoses upon their arrival in Canada as part of a mandatory medical screening process required to obtain a working visa.

Jabulani Muzhizhizhi, ACCM newcomers support program coordinator, said that some migrants can feel alienated from their own cultural backgrounds after being diagnosed as HIV-positive. This is especially prevalent for those immigrating from countries where queerness is stigmatized or where toxic masculinity is the norm.

The New Horizons program, Muzhizhizhi said, aims to offer newcomers a sense of community during a time when living with HIV can feel especially isolating.

Roundtable discussions are a regular feature at these workshops. Topics like “migration stories” and “celebrating cultural traditions” are highlighted in the first weeks of the program to remind participants that they’re not alone.

“There is power in sharing,” Muzhizhizhi said. “If you know someone also faced the same stuff that you faced—that’s how bonds form.”

Prejudice was the first thing Mendoza was able to let go of after participating in ACCM’s workshops.

He explained that in Colombia, individuals living with HIV can become the target of attacks, particularly from extremist groups who unjustly perceive them as deliberately spreading HIV.

However, Mendoza said that the support of ACCM gave him the space to release the feelings of stigma that had previously been buried beneath the surface.

“I was finally able to expose that here,” he said, “and I felt safe that nothing was going to happen to me.”

Overcoming language barriers 

As the only non-francophone HIV/AIDS care centre in Montreal, support services department manager Miguel Cubillos said that ACCM faces a distinct responsibility to offer a comprehensive range of services.

Their staff is not only equipped to provide emotional support and guidance through the healthcare system, but they also assist with the immigration process by accompanying newcomers to immigration hearings or connecting them with legal support.

According to Cubillos, language is often a barrier that stands between a newcomer with HIV and access to medical documents, treatment options and education about HIV-positive prevention.

“We have a high responsibility with the population we serve because we are a minority,” Cubillos said, referring to the fact that many participants in the newcomers program are not native French nor English speakers.

For Israel Mohamed Conteh, a court reporter from Sierra Leone who fled to Canada after receiving threats over his journalism, ACCM became “one of the greatest pillars of support.” Being diagnosed as HIV-positive upon his arrival, Conteh turned to the organization for help, particularly in accessing French language courses essential for finding employment.

Since arriving in Montreal in 2024, Conteh financially supports his wife and child, who live in Guinea.

A former scout, Conteh does not back down from challenges. Despite facing numerous obstacles on his path to fluency in French, he refuses to seek work in an English-speaking province.

He views his time in Quebec as a chance to fulfill a lifelong goal.

“God brought me to Quebec for a particular reason,” Conteh said with a characteristic smile. “That reason? All my life, I’ve been among people that speak French.”

While living in Sierra Leone, Conteh worked as a COVID-19 and Ebola support counsellor, helping people navigate their next steps after receiving a diagnosis. Now, as he begins a new chapter in Canada, he believes he must “counsel himself” through his own diagnosis—this time, with the support and guidance of ACCM.

“You must live with [HIV] for eternity,” he said. “But once you accept it and take your medication, it will help you greatly.”

Delays and costs in medical care

Many migrants, whether diagnosed with HIV upon arrival or aware of their status before coming, face delays in being connected to care.

Isabelle Boucoiran, a researcher and OB/GYN at CHU Sainte-Justine who specializes in caring for pregnant women living with HIV, says that some of her patients have had to wait up to one month before being referred to a specialist.

Delays like that, she said, can be the difference between preventing or allowing vertical transmission—the passing of HIV from mother to child.

“For newcomers, when they arrive in Canada, there is so much going on,” Boucoiran said. “When you are struggling to find a place to live, doing your test is not your priority at all.”

At ACCM, much of the work revolves around being the on-ramp to care. Last year alone, Cubillos said that the organization supported 110 clients through its newcomers program, many of whom needed to connect to an HIV clinic.

While HIV medication for refugee claimants is completely covered by the Interim Federal Health Program, newcomers with HIV coming to Canada under a working visa can struggle to find employment that covers treatment under insurance.

With data from 225 pregnancies from 2019-2023, across CHU Sainte-Justine, CHU de Quebec-Laval and CUSM, Boucoiran said that the median out-of-pocket cost for antiretrovirals during pregnancy before insurance was around $2,300 for non-permanent residents. This is over four times the amount paid by Canadian citizens or permanent residents, she added.

Some of Boucoiran’s patients, particularly women from African countries where antiretrovirals are free, arrive in Canada with six to nine months’ worth of medication, anticipating the difficulties in accessing medication once they arrive.

For migrants who arrive without health or insurance coverage, ACCM partners with pharmaceutical companies like Gilead through compassion programs to provide opportunities to obtain at least six months of medication.

While community organizations like ACCM cannot substitute themselves for formal medical care and rapid linkage to an HIV specialist, they play an important role in bridging the gap during the first years of settlement.

Despite recent provincial cuts to English-service community resources, particularly those related to employment support, ACCM’s newcomers’ program received an increase in allocated funds from the Direction régionale de santé publique in March. The new budget increase was granted following the latest data on HIV rates among Canadian migrants.

With the funding increase running until 2027, Cubillos believes the program will be better positioned to serve youth migrants with HIV, who make up a large proportion of HIV-positive newcomers.

The organization also hopes to one day have enough resources to tackle migrant food insecurity and expand its food bank through partnerships with grocery stores and restaurants.

Cubillos said that challenges for migrants with HIV will only continue to evolve. However, he said that ACCM staff remain committed to adapting the program as needed, based on the shifting experiences of their members.

“The best reward,” Cubillos said, “is seeing members establish themselves and say: ‘Okay, now I’m here. The limbo situation is gone and I’m flourishing in the country.’”

 

UK: Legal victory for HIV-positive migrant after prolonged detention

High Court grants interim relief and orders the Home Office to release HIV positive detainee

In R(DJR) v Secretary of State for the Home Department AC-2025-LON-000975, the High Court ordered the Secretary of State for the Home Department to release DJR from immigration detention.

DJR had been detained for several months and had been diagnosed with HIV while in detention. Due to the difficulties of him complying with his anti-retroviral medication regime while in detention, the Secretary of State for the Home Department had decided to release him.

However, over two months later, DJR had not been released and the Secretary of State for the Home Department had refused two applications for accommodation, despite insisting that he needed to be provided with accommodation before he could be released.

DJR initially asked the Court to order his release without accommodation, however, the Court was reluctant to make such an order because this might potentially lead to a breach of his post-sentence supervision requirements.

Instead, the Court decided to order the Secretary of State for the Home Department to provide DJR with accommodation on an urgent basis so that he could be released.

Australia: Brazilian migrants recount their experience from diagnosis to new beginnings in Australia

‘Life doesn’t end when you are diagnosed with HIV: it’s a new beginning’

Augusto, 32, from Brisbane, and Carolina, 38, from Byron Bay receive free medical treatment in Australia, a service available to everyone, including foreign students. With the medication they receive, Luiz and Carolina’s viral load is so low that they are able to lead a completely healthy life. They decided to talk to SBS Portuguese to reduce the stigma surrounding people living with HIV.

SBS in Portuguese interviewed Brazilians living with HIV in Australia, Augusto, from Brisbane who has been living with HIV for over ten years and Carolina, from Byron Baywho received a positive result two years ago.

To protect the privacy of both, their names have been changed.
Discovering the positive result for HIV
“I was deteriorating. Some days I could go to work; other days, I felt too weak. My family inquired about my delayed results and discovered I was HIV positive. That’s how my journey with HIV began, still in Brazil,” he recalled.
Carolina decided to get tested in New South Wales after discovering her boyfriend had been cheating on her.
Initially, the doctor hesitated to request the test, arguing that she wasn’t part of high-risk groups. However, after insisting, she was tested.
“My discovery was shocking. It changed my life forever, because the result came back positive for HIV,” she shared.
She remembers the doctor initially hesitating to request the exam, arguing that Carolina did not fit the risk group because she was heterosexual, but after the patient’s insistence, the test was performed.
Reaction to the Diagnosis: Always Seek Professional Help
Reactions to an HIV diagnosis vary. Augusto accepted it almost immediately, while Carolina faced deep distress, even contemplating suicidal thoughts.
“I accepted my condition and took care of myself. There are always doubts and stigmas, but over time, you learn to cope,” Augusto said.
Carolina, however, recounted, “it felt like the ground disappeared beneath my feet. I had no knowledge of HIV. I was on a student visa in a foreign country and thought it was the end of my journey and my Australian dream.”
“I received support from Positive Life NSW, an NGO that helps people living with HIV here in Australia.”

Augusto also found assistance: “I highly recommend the Melbourne Sexual Health Centre. They treated me with great care, provided free treatment when I was an international student, and even arranged an interpreter.”
The importance of medical treatment: undetectable = untransmittable (U=U)
Those who follow antiretroviral treatment become undetectable, meaning their viral load is so low that it cannot be detected or transmitted. As a result, they can live completely healthy lives.

Both Augusto and Carolina are currently undetectable.

HIV doesn’t prevent you from studying, working, living a healthy life 
As both our interviewees had to navigate diagnosis and treatment in and out of Australia fears of losing heir visas status always hanged over their heads.

Augusto, who is now an Australian citizen, shares his experience: “A Brazilian migration agent told me it would be impossible to get permanent residency as I am living with HIV. But I didn’t give up and sought a second opinion from a different agent, who was amazing and explained the steps I could take.”

Carolina successfully applied for permanent residency and soon will become a citizen.
“The visa process wasn’t easy. For someone with HIV, you need a health waiver. My doctor confirmed I was undetectable, and with a specialist lawyer, we demonstrated that my condition wouldn’t affect my ability to contribute to the country.”
Serodiscordant relationships can be healthy and happy
A serodiscordant relationship is when one partner has HIV, and the other does not. Both Augusto and Carolina are in such relationships.

“When I told my boyfriend in 2017, he said he didn’t mind and loved me the same way. The most important thing is that I continue my treatment, and we can have a completely normal life,” Augusto said.

Carolina added, “After my diagnosis, I started a relationship with a man who doesn’t have HIV. He helped me realise that HIV doesn’t define who I am and that our relationship could be completely normal as long as I follow my medical treatment.”
Serodiscordant relationships are healthy and happy
In a serodiscordant relationship, one partner is living with HIV and the other is not. Augusto and Carolina are in serodiscordant relationships where their current partners are not living with HIV.

Augusto told his boyfriend, when he met him in 2017, that he was a person living with HIV.

“When I told him about my serology, he said that he didn’t care about it and that he loved me the same way. The most important thing is that I continue to do my treatment and then we could have a completely normal life, both of us being healthy and happy.”

“Soon after my diagnosis, I began a relationship with a man who is not living HIV-positive, and he was fundamental to my recovery process. He took care of me when I was depressed because of the diagnosis and he was the one who educated me about HIV. He made me realise that HIV doesn’t define who I am, and that our relationship could be completely normal, as long as I get my medical treatment.”
Having a Baby When You Are Living with HIV
With treatment and medical supervision, it is possible to have a safe pregnancy.

Carolina shared her dream: “I’m so excited I am able to have children! I take daily medication that suppresses the virus, making it undetectable, it won’t be transmitted to the baby.”

‘Life doesn’t end when you are diagnosed with HIV: it’s a new beginning’
At the end of the podcast, Augusto and Carolina shared messages for those newly diagnosed with HIV.

“I’ve been living a normal life since I found out I was HIV positive about 10 years ago. Life doesn’t end when you discover you have HIV, it just reboots,” Augusto said. “I take my medication every day, exercise, and follow my treatment.”

“Although the diagnosis may be a shock at first, it’s possible to live a healthy and full life with the right treatment. Being well-informed opens the doors to effective treatments. My message is one of hope: yes, it is possible to live a completely normal life, even with HIV,” said Carolina.

HIV (Human Immunodeficiency Virus) can be transmitted through unprotected sex, sharing contaminated needles, and from an untreated HIV-positive mother to her baby during pregnancy, childbirth, or breastfeeding.

People living with HIV in Australia can find support, free medical treatment, and specialised services at various organisations across the country.

Victoria – Living Positive Victoria or

Melbourne Sexual Health Centre
New South Wales (NSW) –

Positive Life NSW

or Multicultural HIV and Hepatitis Service (MHAHS)

Queensland – Queensland Positive People (QPP) or Queensland Council for LGBTI Health Northern
Territory – NAPWHA Peer Support (National Association of People) with HIV Australia) South Australia – SAMESH (South Australia Mobilisation + Empowerment for Sexual Health)
Tasmania – Tasmanian Council on AIDS, Hepatitis and Related Diseases (TAScaHRD)
Canberra – HIV/AIDS Legal Centre (HALC) or Canberra Sexual Health Centre

Botswana: Following free ARV programme for non-citizens, adverse birth outcomes improve

Free antiretroviral therapy for non-citizens in Botswana: a further step towards the elimination of HIV

Following the expansion of antiretroviral therapy to migrants and non-citizens in Botswana, gaps have narrowed in the uptake of antenatal care and antiretroviral therapy during pregnancy between citizens and non-citizens living with HIV. Disparities in adverse birth outcomes were no longer observed after the change in policy, according to a report in the Journal of the International AIDS Society.

In Botswana, approximately 25% of female citizens aged 15 to 49 are living with HIV. Back in 2002, the government of Botswana launched a free universal antiretroviral therapy programme, which has proven to be very successful, including by improving birth outcomes of infants born to women with HIV. However, access to this programme was restricted to citizens of Botswana only, although non-Botswanan citizens represent as high as 7% of the country’s total population. Many are migrants from neighbouring countries with large HIV epidemics, such as Zimbabwe, Zambia and South Africa, with 13%, 11% and 19% HIV prevalence, respectively.

Only 29% of migrants in Botswana had personal health insurance or could afford to pay for HIV care, and research has shown that migrants had worse health outcomes than citizens of Botswana. Evidence has also shown that stigmatisation by healthcare and security staff in medical facilities were barriers to receiving care. Furthermore, pregnant non-citizens were less likely to receive antenatal care and more likely to receive care later in pregnancy, deliver at home and experience adverse birth outcomes than pregnant citizens of Botswana.

At the end of 2019, the government of Botswana drastically shifted its policy by authorising the free distribution of antiretroviral therapy to non-citizens living with HIV.

Dr Christina Fennel from Harvard University, with colleagues in Botswana and the US, evaluated the impact of this major policy change on antenatal care, antiretroviral therapy use and adverse birth outcomes among infants. For this, they compared outcomes in infants born to citizens and non-citizens living with HV, before (2014-2019) and after (2019-2021) the policy change. They used data from the Tsepamo Surveillance Study, a large birth outcomes surveillance programme that collects data from maternity sites in Botswana, including about 72% of all births in the country.

More specifically, the impact analysis was based on data from maternal records. Adverse birth outcomes analysed were preterm delivery, very preterm delivery, stillbirth, neonatal death, small for gestational age (babies smaller than usual for the number of weeks of pregnancy) and very small for gestational age. Because multiple births may be associated with adverse birth outcomes, only singleton births were included in the analyses of adverse birth outcomes.

Results

During the entire analysis period – 2014 to 2021 – there were 47,576 live deliveries and stillbirths among pregnant women with HIV recorded in the Tsepamo study, including 47,443 with known citizenship status – 45,917 (97%) Botswanan citizens and 1,516 (3%) non-citizens.

The proportion of non-citizens with unknown HIV status decreased significantly in the post-expansion period, from 6% to 1% (p < 0.001), whereas it remained the same (0.5% vs 0.4%; p = 0.02) for citizens.

The proportion of non-citizens with HIV attending antenatal care increased from 79% in the pre-expansion period to 87% following expansion, whereas attendance among citizens with HIV remained constant through both periods at approximately 96%. (Non-citizens can attend antenatal care by paying a modest fee, which did not change through the study period).

In the pre-expansion period, 65% of non-citizens received antiretroviral therapy, of whom only 7% had a dolutegravir-based regimen. After 2019, the proportion on antiretroviral therapy increased significantly to 90%, narrowing the gap with citizens (97%). Also, the proportion of non-citizens and citizens receiving dolutegravir almost equalised (42% vs 44%), showing a decrease in the use of old antiretrovirals such as nevirapine, which have a higher risk of adverse birth outcomes.

Regarding adverse birth outcomes, in the pre-expansion period infants born to non-citizens with HIV had significantly greater risks of preterm delivery (aRR = 1.28; 95% CI: 1.11, 1.46), very preterm delivery (aRR = 1.89; 95% CI: 1.43, 2.44) and neonatal death (aRR = 1.69; 95% CI: 1.03, 2.60) when compared with infants born to citizens with HIV. For reasons that are not clear, non-citizens had a reduced risk of having an infant who was small for gestational age (aRR = 0.75; 95% CI: 0.62, 0.89).

After the expansion of antiretroviral therapy, none of the adverse birth outcomes were significantly higher among infants born to non-citizens with HIV than infants born to citizens with HIV.  Also, there were declines in adverse birth outcomes among infants born to non-citizens, including preterm delivery (23% in 2014-2019 vs 14% in 2019-2021) and stillbirth (4% vs 3%). At the same time, no changes in birth outcomes for HIV-negative non-citizens were observed.

According to Fennel and colleagues, their findings suggest that greater access to antiretroviral therapy – including modern regimens – may have reduced adverse birth outcomes. They also underscore the substantial decrease of the proportion of pregnant non-citizens with unknown HIV status, as well as increased linkage to HIV therapy and antenatal care after the policy change.

In 2022, Botswana was praised for reaching, ahead of the 2025 target, the UNAIDS goals of 95% of all people living with HIV to be aware of their status, 95% of those aware of their status to receive sustained antiretroviral therapy, and 95% of people receiving this therapy to achieve viral load suppression. The results of this study further confirm that Botswana has become a model for other countries that may still hesitate to scale-up access to antiretroviral therapy and HIV care for all minorities, including migrants, not to mention those countries that might be tempted to introduce new restrictions.

References

Fennell C et al. The impact of free antiretroviral therapy for pregnant non-citizens and their infants in Botswana.Journal of the International AIDS Society 2023, 26:e26161 (open access).

https://doi.org/10.1002/jia2.26161

 

Cyprus: Decision to deport HIV positive student on the grounds of “carrying an infectious disease” is reversed

Deportation of HIV student halted after uproar

The civil registry and migration department on Saturday responded to being lambasted for ordering the deportation of a third-country student because he was HIV positive, saying they would be issuing him a residence permit under certain health conditions.

The Aids Solidarity Movement earlier in the day condemned the deportation order, labelling it an act of “severe discrimination” and calling for the reversal of the decision.

According to the statement, the student was informed by the civil registry and migration department on March 16 by letter that he would be deported on March 21 on the grounds of “carrying an infectious disease”.

The movement said that this decision completely ignored letters of support from both the Gregorios treatment centre and the Solidarity Movement itself, as well as the guidelines of the World Health Organisation, which state “that when a person living with HIV has an undetectable viral load, due to the effective medication they receive, they cannot transmit the virus, even through unprotected sex”.

“The student has access to medication from his country, does not burden the state in any way in relation to his antiretroviral treatment or medical supervision, and does not pose a risk to public health,” the statement added.

Moreover, with the student’s written consent, the movement sent his medical results, along with a note from Doctor Ioannis Demetriades, the head of the Gregorios Clinic and the head of the ministry of health’s HIV and Aids programme, to the migration department’s acting director, asking that the student be allowed to complete his studies.

“We denounce this serious discrimination based on the HIV status of an individual and demand the immediate change of the decision from all the competent bodies of the state that support human rights,” the statement concluded.

Later on Saturday a statement from the migration department said it would in the end be issuing the residence permit after receiving a confirmation from the competent medical services of the state that the student was not contagious.

The condition of the permit is that the student receive regular health checks at the Gregorios Clinic.

It added that it had only been following the law, which “prohibit entry into the country, or carry out deportations for those persons who are carriers or suffer from communicable or infectious diseases and which are a danger to public health”.

Cyprus: Migration Department cancels deportation of undetectable HIV-Positive student after backlash

Deportation of HIV student halted after uproar (Updated)

The civil registry and migration department on Saturday responded to being lambasted for ordering the deportation of a third-country student because he was HIV positive, saying they would be issuing him a residence permit under certain health conditions.

The Aids Solidarity Movement earlier in the day condemned the deportation order, labelling it an act of “severe discrimination” and calling for the reversal of the decision.

According to the statement, the student was informed by the civil registry and migration department on March 16 by letter that he would be deported on March 21 on the grounds of “carrying an infectious disease”.

The movement said that this decision completely ignored letters of support from both the Gregorios treatment centre and the Solidarity Movement itself, as well as the guidelines of the World Health Organisation, which state “that when a person living with HIV has an undetectable viral load, due to the effective medication they receive, they cannot transmit the virus, even through unprotected sex”.

“The student has access to medication from his country, does not burden the state in any way in relation to his antiretroviral treatment or medical supervision, and does not pose a risk to public health,” the statement added.

Moreover, with the student’s written consent, the movement sent his medical results, along with a note from Doctor Ioannis Demetriades, the head of the Gregorios Clinic and the head of the ministry of health’s HIV and Aids programme, to the migration department’s acting director, asking that the student be allowed to complete his studies.

“We denounce this serious discrimination based on the HIV status of an individual and demand the immediate change of the decision from all the competent bodies of the state that support human rights,” the statement concluded.

Later on Saturday a statement from the migration department said it would in the end be issuing the residence permit after receiving a confirmation from the competent medical services of the state that the student was not contagious.

The condition of the permit is that the student receive regular health checks at the Gregorios Clinic.

It added that it had only been following the law, which “prohibit entry into the country, or carry out deportations for those persons who are carriers or suffer from communicable or infectious diseases and which are a danger to public health”.

New Zealand: HIV no longer blocks residency in New Zealand, but mandatory testing stays

Immigration removes HIV from list of high cost conditions

HIV is no longer considered a high cost condition following a policy review by the Immigration Minister. However, NZ is still among just 18 countries that will require migrants to get an HIV test for a visa or residence.

HIV infection has been removed from Immigration New Zealand’s list of medical conditions deemed likely to impose significant costs or demands on New Zealand’s health services after a review.

Immigration NZ has a list of more than 40 medical conditions, including HIV, deemed to impose “significant costs” on the public health system and/or education services.

Migrants seeking to apply for a work to residence visa have to complete a character test, which includes a police check, as well as a medical check known as the Acceptable Standard of Health (Ash) test.

New Zealand’s publicly-funded health services are tax-funded and provide universal coverage for citizens, residents, and people on work visas staying for more than two years.

An Immigration NZ medical assessor determines whether the applicant is unlikely to impose significant costs on health services to pass the medical test. If applicants don’t meet the Ash requirements then they can seek a medical waiver.

For more than a decade, Immigration NZ has kept the threshold of “significant costs” at $41,000 per year within a period of five years from the date the assessment against health requirements is made or a lifetime if it is a chronic condition.

After years of advocacy, Immigration NZ has decided to remove HIV infection from the list.

However, New Zealand will continue to require HIV testing as a requirement for visa applicants intending to stay for more than 12 months, along with all other existing examination and test requirements.

INZ policy integration director Nick Aldous says the decision to remove HIV infection from Immigration NZ’s list of high-cost health conditions is because it is now considered to be a manageable chronic illness, and treatment costs are no longer considered significant.

However, Aldous says the continued testing requirement for visa applicants intending to stay in the country for more than a year is because HIV is still considered a serious chronic illness and can present a risk to public health given it’s easily spread through unprotected sexual contact and sharing contaminated needles.

The change came into effect on October 15.

According to the United Nations AIDS Still Not Welcome report published in 2019, 203 countries, territories and areas did not have any HIV-related restrictions on entry, stay and residence.

“We are so glad that the tireless mahi over many years has resulted in this step towards dismantling HIV stigma at an immigration level and has brought our country’s policies closer in line with the latest scientific and public health recommendations. It’s a proud moment.”
– Jason Myers, New Zealand AIDS Foundation

New Zealand is among 18 countries that still did, including Australia and Israel.

In a letter to the New Zealand AIDS Foundation, Immigration NZ chief medical officer Rob Kofoed said the removal of HIV infection from the list meant the individual health circumstances of each visa applicant with the condition could be assessed on a case by case basis.

INZ was previously obliged to determine that a resident visa applicant with HIV did not have an acceptable standard of health.

​​New Zealand AIDS Foundation chief executive Jason Myers said the decision came as a relief.

With appropriate treatment, he said, people living with HIV who maintained undetectable viral load do not transmit the virus through sexual contact, and treating HIV here no longer poses significant costs on the public health budget.

“We are so glad that the tireless mahi over many years has resulted in this step towards dismantling HIV stigma at an immigration level and has brought our country’s policies closer in line with the latest scientific and public health recommendations. It’s a proud moment.”

Myers did not comment on the requirement for testing still being part of the visa and residence process.

An Indian migrant, who did not want to be named, told Newsroom he is relieved by the news.

The man who was tested positive for HIV last year says INZ’s policy added to the anxiety and uncertainty he felt when he first learnt of his diagnosis.

“There is still a lot of stigma attached to it back home. I had many sleepless nights. I didn’t know how to tell my family back home, or work,” he says.

“I contacted lawyers last year who told me it is going to be really hard to apply for residency because it’s not up to acceptable health standards.”

But the man says removing the condition from the high cost list was “life changing” for him.

“I feel like the battle is finally over. No more having to convince immigration and the Ministry of Health. I think it’s a celebration for migrants.”

But he says INZ should do away with the ongoing requirement of testing for HIV, as it has removed it from the list of medical conditions.

“It’s irrelevant. If they’re removing it from the list, then why would you want to do the test? That’s not clear to me.”

Green Party MP Ricardo Menéndez March is seeking a full review of the “ableist” medical requirements from Immigration Minister Kris Faafoi.

Menéndez March said ideally the list should be removed from the health criteria qualifying residency, saying he was disappointed that migrants would still be required to undertake HIV tests for visas.

“For too long the Government has stigmatised migrants living with HIV and prevented them from being able to obtain visas on the basis of their diagnosis.

“Mandatory HIV testing for migrants only compounds to the existing stigma and the Ministry of Health released a report making it clear HIV testing should remain voluntary and only undertaken with the patient’s knowledge, consent and understanding that an HIV test is recommended.”

Disability advocates have also been calling on INZ to remove these medical requirements.

Faafoi told Newsroom last week he planned to review the Ash threshold.

“The details of the health requirements are still being worked through and will be made publicly available once immigration instructions have been signed.”

The Ash requirements for the newly announced one-off 2021 Resident Visa would not be reviewed, he said.

“The health requirements will be limited and will only screen for the most serious health conditions.”

Nepal: How critical HIV medicine reached a traveler stranded in Nepal during the pandemic

Stranded in Nepal without HIV medicine

Wang Tang (not his real name) had never been to Nepal before, but at the end of March 2020 it was one of the few countries that had not closed its borders with China. Since he was desperate to get away from Beijing after having had to stay at home for months after the coronavirus outbreak spread throughout China, he bought a ticket.

But days after he arrived, while he was staying in Pokhara, the fourth stop on his trip, the local government announced that the city would be shut down. He heard that the lockdown would not last longer than a month.

As someone who is living with HIV, he had brought along enough HIV treatment to last for a month. However, he soon learned that the re-opening of the city was to be postponed, which meant that he was at risk of running out of the medicine he needed to take regularly in order to suppress his HIV viral load and stay healthy.

Mr Wang swallowed hard while counting the remaining tablets. He had no idea how to get more.

As the lockdown dragged on, it seemed that no end was in sight. Mr Wang started to take his medicine every other day so that his supply would last a little bit longer.

He contacted his friends back at home, hoping that they could send medicine to Nepal, but they couldn’t. The country was under lockdown—nothing could be imported.

Then, Mr Wang contacted his friend Mu-Mu, the head of Beijing Red Pomegranate, a nongovernmental organization providing volunteer services for people living with HIV. It was with Mu-Mu’s help that Mr Wang learned how to obtain HIV treatment after he was diagnosed as living with HIV. Having known each other for many years, Mu-Mu had the trust of his friend. Mu-Mu contacted the UNAIDS Country Office for China to see if it was possible to deliver medicines to Mr Wang. A UNAIDS staff member quickly got in touch with the UNAIDS Country Office for Nepal.

Everything happened so quickly that Mr Wang was shocked when he received a message from Priti Acharya, who works for AHF Nepal and had been contacted by the UNAIDS Nepal office, saying that she would bring the medicine to him.

The next day, Ms Acharya rode her motorbike for 15 km on a dusty road before reaching the place where she would meet Mr Wang. When he came down from the mountains to meet her, Ms Acharya, drenched in sweat, was waiting under the midday sun.

“I was so happy and thankful for her hard work. She gave me a sunny Nepalese smile in return, as well as detailed instructions on the medicine’s dosage,” said Mr Wang.

They took a photograph together, then Mr Wang watched Ms Acharya as she left on her motorbike. Her image, disappearing in the distance, is carved into his memory. To attend the five-minute meeting, Ms Acharya had to ride a round trip of more than 30 km.

“For half a month or so, I had been suffering from pain and anxiety almost every day due to the lack of medication and the loneliness of being in a foreign country on my own. I could not believe that I got the HIV medicine in such a short time,” said Mr Wang. After the trip, he wrote to thank Ms Acharya, explaining how important the medicine he now had in his hand was: “it’s life-saving.”

At the end of his stay in Nepal, Mr Wang wanted to do something for UNAIDS. As he is an experienced photographer, he volunteered to carry out a photo shoot for UNAIDS’ Nepal office.

The subject he chose was former soccer player Gopal Shrestha, the face of an HIV charity in Nepal and the first person living with HIV to reach the summit of Mount Everest. After his HIV diagnosis in 1994, Mr Shrestha launched the Step-Up Campaign and spent many years climbing mountains worldwide, hoping to give strength and hope to people living with HIV.

In 2019, Mr Shrestha reached the peak of the world’s highest mountain, Mount Everest, recording a historic breakthrough for people living with HIV. “If 28 000 people have already climbed Mount Everest, why can’t I?” he said. “By climbing the highest mountain in the world, I want to prove that we are no different from anyone else and that we can all make a difference.”

“The moment I saw him, I could tell he was a sophisticated man,” said Mr Wang. Without instructions, Mr Shrestha posed naturally in front of the camera. He displayed confidence and charm. His eyes, content and clear, reflected nature’s beauty. “The eyes surely are the window to the soul,” Mr Wang said.

Mr Wang is looking forward to his next trip to Nepal. After the pandemic, Pokhara’s lakeside will be flooded with tourists, and he looks forward to seeing the mountain town bustling with people like it used to.