New Zealand: Government expands access to HIV prevention tools to all, regardless of visa status

Burnett Foundation Aotearoa welcomes the decision to expand access to HIV prevention tools

The Government’s decision to expand access to HIV prevention tools to all people in New Zealand, regardless of their visa status, is a great step forward for common-sense and evidence-based HIV prevention.

The change, enabled by The Healthy Futures (Pae Ora) (Eligibility) Regulations 2026, will come into effect on 1 December, quite appropriately, on World AIDS Day.

Under the new rules, publicly funded HIV prevention medicines will be available to anyone in New Zealand who meets the same clinical criteria already used for funded pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). This means eligibility will be based on a person’s risk of exposure to HIV, rather than their visa or immigration status.

In addition to providing access to the medicines themselves, the regulation change also provides for the associated lab testing required to prescribe and monitor treatment.

Burnett Foundation Aotearoa CEO Liz Gibbs says the change removes a longstanding and unnecessary barrier to HIV prevention. “As we learned with COVID-19, viruses do not check passports, visa categories or immigration status. If we are serious about ending HIV transmission in Aotearoa, everyone who could benefit from prevention tools should be able to access them.”

“PrEP is one of the most effective HIV prevention tools we have. Expanding access will help protect individuals, reduce new transmissions and strengthen New Zealand’s overall public health response.”

The Foundation has long advocated for the removal of eligibility barriers to HIV prevention services and welcomed the change as an important step towards New Zealand’s goal of zero locally acquired HIV transmissions by 2030.

Research and international experience show that making HIV prevention tools widely available is one of the most effective ways to reduce new infections. Ensuring that people can access PrEP based on risk rather than visa status will improve equity, reduce preventable HIV transmissions and help New Zealand maintain progress towards ending HIV transmission.

The change is particularly important given the mobile nature of communities across Aotearoa and the wider Pacific. Ensuring everyone at risk can access prevention services benefits both individuals and the broader community.

While welcoming the announcement, Burnett Foundation Aotearoa says further action is needed to ensure access to PrEP is practical and consistent.

“We’ve removed one important barrier, but there are still others,” says Gibbs.

“We also need funding to enable pharmacists to supply PrEP under appropriate clinical arrangements. This would make access faster and easier, particularly for people who may not have a regular GP, fear stigma in small communities, or who face long waits or long trips for appointments.”

Burnett Foundation Aotearoa will continue working with Health New Zealand, primary care providers and community stakeholders to ensure the benefits of the new regulations translate into real-world improvements in access to HIV prevention services.

“This shows what can be achieved when public health policy follows evidence,” says Gibbs.

“World AIDS Day is an appropriate day for these changes to take effect. It’s a reminder that ending HIV transmission is possible, but only if everyone who needs prevention, testing and treatment can access it.”

Russia: New rules require health services to report HIV among foreign nationals

Medical organisations required to report foreign nationals’ HIV infections to the Ministry of the Interior

Translated with Deepl.com – Scroll down for original article in Russian.

Medical organisations will be required to provide the Ministry of the Interior and Rospotrebnadzor with information on infections among foreign nationals, including HIV, and cases of drug use, should such cases be identified whilst providing medical care. This was reported by the press office of the Russian Ministry of Health, according to ‘Interfax’.

The ministry has drawn up a draft order to this effect. The initiative is aimed at safeguarding the public health and epidemiological well-being of the Russian population and ensuring the accuracy of information regarding the medical assessments of foreign nationals, the ministry clarified.

The draft has been drawn up to implement the law requiring foreign nationals to undergo a medical examination within 30 days of entering Russia and annually thereafter. Foreign nationals themselves must pay for these examinations.

All medical certificates will be in electronic form and will be stored in the Unified State Healthcare Information System (EGISZ). Healthcare organisations will be required to transmit the information to the Ministry of the Interior and Rospotrebnadzor within 24 hours to prevent documents from circulating outside the system.

Russian President Vladimir Putin signed a law in June establishing a standard timeframe for compulsory medical examinations for foreign nationals. According to the document, migrant workers and foreign nationals planning to stay in Russia for more than 90 days must undergo a medical examination within 30 days of entering the country.

The examination includes testing for drug use, dangerous infectious diseases and HIV. The costs of the medical examination are borne by the foreign nationals themselves or their employers, and it may only be carried out by authorised medical organisations.

Медорганизации обяжут сообщать в МВД о ВИЧ-инфекциях иностранцев

Медицинские организации должны будут передать в МВД и Роспотребнадзор сведения об инфекциях иностранцев, в том числе о ВИЧ-инфекции, и случаях употребления наркотиков, если такие будут выявлены во время оказания медицинской помощи. Об этом сообщилив пресс-службе Минздрава России, передает «Интерфакс».

Ведомство разработало соответствующий проект приказа. Инициатива направлена на сохранение санитарно-эпидемического благополучия населения России и обеспечение достоверности сведений о медзаключениях граждан других стран, уточнили в министерстве.

Проект разработан для реализации закона, обязующего иностранцев проходить медосмотр в течение 30 дней с моменте въезда в Россию и далее ежегодно. При этом оплачивать прохождение осмотра должны сами граждане других стран.

Все медицинские заключения будут в электронной форме, их разместят в Единой государственной информационной системе здравоохранения (ЕГИСЗ). В течение суток медорганизации должны будут передать информацию в МВД и Роспотребнадзор, чтобы избежать оборота документов вне системы.

Президент России Владимир Путин подписал закон, устанавливающий единый срок обязательного медицинского освидетельствования для иностранных граждан, в июне. Согласно документу, проходить медосмотр в течение 30 дней после въезда в страну должны трудовые мигранты и иностранцы, планирующие находиться в России более 90 дней.

Обследование включает проверку на употребление наркотических веществ, наличие опасных инфекционных заболеваний и ВИЧ. Расходы на медосвидетельствование возлагаются на самих иностранцев или их работодателей, а проводить его смогут только уполномоченные медицинские организации.

Zimbabwe: Virtual health platform helps to prevent treatment interruption among returning migrants

Digital tools help Zimbabwe’s HIV migrants stay in care

As droves of Zimbabweans return home from South Africa in a wave of deportations and anti-immigrant sentiment, health experts warn that disruptions to HIV treatment could leave many at risk unless returnees are quickly reconnected to care.

The South African government says more than 53,000 foreign nationals have been processed for deportation or repatriation as part of a crackdown on “irregular migration” following weeks of violent anti-immigration protests. Most of the returnees are from Malawi, Zimbabwe and Mozambique.

According to Statistics South Africa, Zimbabweans constitute one of the country’s largest migrant communities, with an estimated one million living there.

“We know that displacement, whether planned or sudden, can disrupt treatment, resulting in missed medication, poor health outcomes and increased risk of opportunistic infections.”

Tatenda C. Makoni, executive director, ZNNP+

Research in South Africa’s Gauteng province, which carries the country’s largest HIV burden, found HIV prevalence among international migrants to be around 10 per cent.

For many migrants living with HIV, sudden displacement presents immediate risks. Medication may be left behind, treatment records lost, and patients may struggle to navigate health systems on their return.

“The disruption is not just about the medicines,” Efison Dhodho, research coordinator at Zimbabwe’s Biomedical Research and Training Institute, told SciDev.Net.

“Many returnees may have lost their treatment records, some fear accidental disclosure of their HIV status when they return to their communities, while others are dealing with the psychological stress of suddenly losing their livelihoods.”

Health authorities in Zimbabwe, which has one of Southern Africa’s largest HIV treatment programmes, say they are responding through a combination of digital health and patient-centred care models designed to prevent treatment interruptions among mobile populations.

Owen Mugurungi, director of the AIDS and TB unit in Zimbabwe’s Ministry of Health and Child Care, said the ministry was working with the Zimbabwe National Network of People Living with HIV (ZNNP+) and others to make sure everyone who needs antiretroviral drugs can accesses them.

The Zimbabwe National AIDS Council (NAC) urged returning migrants with HIV to enrol immediately into Zimbabwe’s HIV treatment programme upon arrival.

“What I know, and what I want to encourage, is for people living with HIV who are returning, when they get to their respective homes, to go to the nearest health facility and be absorbed into the very robust HIV treatment programme which we have in Zimbabwe,” said NAC chief executive officer Bernard Madzima.

“We have capable health workers at every facility in the country, from clinic level up to the highest referral hospitals, so there should be no problem in terms of them being integrated into this system.”

‘Omalayitsha’ network

Madzima noted that many Zimbabweans working in South Africa had been accessing six-month supplies of antiretroviral medicines from Zimbabwe through an informal cross-border transporter network known as “omalayitsha”, allowing them to remain on treatment while living abroad.

However, he said more people are now returning permanently and need to be fully integrated into local HIV services.

Mental health challenges, stigma and the practical realities of displacement can all affect adherence to treatment, said Dhodho, who has worked on Zimbabwe’s HIV care strategies for migrant populations.

“If your life is suddenly disrupted and you’re forced to leave, your medicines may be left behind,” he explained.

“Even a short disruption in routine can affect adherence. HIV treatment works best when people maintain viral suppression, which protects both their own health and helps prevent onward transmission.”

Dhodho said the country had already developed approaches, including the omalayitsha model, which could help returning migrants reintegrate into care more effectively.

However, he added that omalayitsha depends on predictable travel patterns and stable living arrangements, both of which have been disrupted by the recent wave of deportations.

Telehealth solutions

To bridge that gap, ZNNP+ has expanded the use of Kutabila, a virtual health platform that links returning migrants with HIV treatment and care services.

“The recent increase in the number of Zimbabweans returning home from South Africa, coupled with reports of deportations and heightened anti-foreigner sentiment, raised concerns about the continuity of HIV treatment among people living with HIV,” said Tatenda C. Makoni, executive director of ZNNP+.

“We know that displacement, whether planned or sudden, can disrupt treatment, resulting in missed medication, poor health outcomes and increased risk of opportunistic infections.”

Through telephone-based counselling and referral services, trained counsellors assess callers’ treatment needs, direct them to the nearest health facility and provide adherence counselling and psychosocial support.

Between 1 June and 8 July, the platform received more than 300 calls from returning migrants, according to Makoni. He said most were seeking help on restarting treatment, replacing lost medical records, transferring HIV care from South Africa or accessing medicines after treatment interruptions.

Since its launch, Kutabila has handled more than 10,500 client interactions and successfully linked over 7,300 people living with HIV to treatment and care services, he added.

Empathy approach

Zimbabwe is also applying lessons from Uzwelo, meaning empathy, a person-centred approach developed after the COVID-19 pandemic to re-engage people who had interrupted HIV treatment.

Rather than focusing only on tracing people who miss clinic appointments, Uzwelo encourages healthcare workers to understand the individual circumstances that caused treatment interruption and develop care plans tailored to each patient’s situation.

According to Dhodho, who helped develop the approach, Uzwelo helped recover nearly a quarter of patients who had fallen out of care within just three months after being introduced in pilot districts.

“The health worker meets the client with empathy instead of judgement,” he explained.

“The question becomes, ‘How do we make treatment work for your circumstances?’ rather than ‘Why did you default?’”

Makoni believes such innovations offer lessons that extend beyond Zimbabwe.

“Migration is a regional issue, and ensuring continuity of HIV treatment requires regional solutions,” he said.

“Continuity of HIV treatment should not stop at national borders.”

This piece was produced by SciDev.Net’s Sub-Saharan Africa English desk.

National Health Insurance Act could deny refugees, asylum seekers and undocumented migrants HIV treatment

South Africa’s NHI Act Risks Fueling Anti-Immigrant Sentiment by Restricting HIV Treatment

Health Minister Aaron Motsoaledi defends the controversial Section 33, drawing criticism that the policy could deny life-saving care to asylum seekers and undocumented migrants.

As violent xenophobic protests demanding the mass expulsion of foreign nationals sweep across South Africa, a highly contentious legislative battle regarding the National Health Insurance (NHI) Act is threatening to compound the crisis. Public health advocates are sounding the alarm over specific clauses embedded within the sweeping healthcare reform that could legally strip refugees, asylum seekers, and undocumented migrants of access to life-saving HIV treatments.

The controversy places Health Minister Dr. Aaron Motsoaledi at the center of a profound ethical and epidemiological dilemma. While the administration champions the NHI as the ultimate equalizer for South Africa’s deeply fractured healthcare system, the deliberate exclusion of vulnerable migrant populations risks triggering a devastating public health catastrophe. The resulting policy friction threatens to not only derail the nation’s world-leading antiretroviral program but also validate the very anti-immigrant rhetoric currently destabilizing the nation.

What Exactly Does Section 33 Entail?

The architectural core of the controversy lies within Section 33 of the NHI Act. The legislation mandates the effective abolition of private medical aids in their current form, relegating them to merely providing top-up coverage for services not subsidized by the state fund. The economic logic is clear: re-route the massive capital currently spent by the wealthy on private medical schemes (representing 15% of the population) into a centralized, universal pool to serve the remaining 85%.

However, the eligibility criteria for this universal pool are rigidly nationalistic. The state’s Health Patient Registration System (HPRS) is designed to integrate strictly with Department of Home Affairs databases. South African citizens, documented permanent residents, and formally recognized refugees will be integrated. Conversely, undocumented migrants and asylum seekers trapped in South Africa’s notoriously backlogged immigration system will be categorically excluded from comprehensive coverage.

Critics point to a damning Treasury letter from acting Director-General Ismail Momoniat, which warned that the legislation is aggressively “unfriendly” to asylum seekers, noting that “even children [are] not entitled to hospital care unless in an emergency.”

How Will This Affect Asylum Seekers and Refugees?

The immediate casualty of this legislative exclusion is infectious disease management, primarily HIV/AIDS and tuberculosis. South Africa currently operates the largest antiretroviral therapy (ART) program in the world, a colossal effort requiring unbroken adherence to prevent viral mutation and community transmission.

If the NHI Act proceeds unaltered, undocumented migrants and pending asylum seekers who currently rely on state clinics for their daily ART regimens will be severed from the supply chain. Public health experts at the Centre for the AIDS Programme of Research in South Africa (CAPRISA) warn that denying treatment based on citizenship status will inevitably lead to massive spikes in viral loads among migrant communities. This policy approach essentially weaponizes the healthcare system, transforming clinics into immigration checkpoints.

Minister Motsoaledi has publicly acknowledged this epidemiological paradox, admitting in interviews that denying infectious disease care to any demographic “works in reverse” regarding national health security. A virus does not recognize border control or passport stamps; unchecked transmission within migrant communities will inevitably spill over into the broader South African populace.

Why Is the Health Minister Standing Firm?

Despite the dire warnings regarding both the collapse of private medical aids and the exclusion of migrants, Dr. Motsoaledi remains unyielding on the foundational architecture of the NHI. In a recent broadcast interview, he declared that Section 33 will not be scrapped, even if it triggers the collapse of the fragile Government of National Unity (GNU).

“You can’t come and tell me ‘I support this universal coverage, but Section 33 must go.’ It’s like supporting a house, but the foundation must go. Don’t you know it’s going to collapse?” Motsoaledi stated. He maintains that preserving the private medical aid sector would perpetuate the apartheid-era inequalities that the NHI was explicitly designed to eradicate.

However, regarding the specific exclusion of migrants, the Minister has signaled a slight pragmatic retreat. He indicated a willingness to adapt regulatory frameworks to ensure that vital interventions—such as HIV treatment, maternal care, and emergency disease surveillance—remain accessible to all populations, regardless of documentation. Yet, without formal amendments to the Act itself, these assurances remain dangerously reliant on ministerial discretion rather than entrenched legal rights.

Are There Parallels in East Africa’s Universal Health Rollouts?

The tension between national healthcare funding and immigrant access is a challenge actively playing out across the continent. In Kenya, the ongoing transition from the National Health Insurance Fund (NHIF) to the Social Health Insurance Fund (SHIF) has sparked similar debates regarding the integration of East African Community (EAC) citizens and the massive refugee populations residing in Dadaab and Kakuma camps.

Unlike South Africa, Kenya’s public health framework heavily relies on international donor partnerships—specifically the UNHCR and global health NGOs—to parallel-fund migrant healthcare, preventing the state treasury from absorbing the entire fiscal burden. Similarly, the United Kingdom’s NHS imposes an immigration health surcharge on visa applicants, creating a financial gateway rather than an outright prohibition on care.

For Pretoria, the path forward is fraught with legal peril. As civil rights organizations prepare constitutional challenges against the NHI Act, the Constitutional Court will ultimately determine if the right to life and basic healthcare supersedes the boundaries of citizenship. Until then, millions of undocumented individuals remain trapped between violent vigilantes on the streets and a healthcare system preparing to close its doors.

Europe’s HIV response cannot succeed without migrant health equity

Europe debates migration, but ignores migrant health

By Tamara Prinsenberg & Daniel Reijer – AHF Europe

Migration dominates political debate across the continent. Governments argue about borders, asylum systems, returns, integration, and security. Election campaigns are built around it. Entire ministries are dedicated to it. Yet one issue remains largely absent: access to healthcare.

This is no marginal issue. Many migrants in Europe still struggle to access even the most basic HIV and STI services.

At AIDS Healthcare Foundation (AHF) Europe, we work with migrants, refugees, undocumented people, labour migrants, international students, and other vulnerable communities across several European countries.

Every day, our teams and partners provide frontline HIV and STI services designed to reach people who would otherwise be excluded. Many of these services are multilingual, community based, anonymous, and specifically designed to reduce fear and stigma. In 2025, AHF Europe provided HIV prevention, testing and linkage-to-care services to more than 28,000 migrants.

For many migrants, accessing healthcare in Europe is far from straightforward. Some do not understand the language used in clinics or hospitals. Others are unsure whether they are legally entitled to care. Some fear that seeking healthcare could negatively affect their migration status. Others simply do not know where services exist or how to navigate an healthcare system that can already be difficult for citizens themselves.

From a public health perspective, this simply makes no sense. Viruses do not care about residency permits or asylum procedures. HIV does not distinguish between documented and undocumented people. If people are pushed away from prevention, testing, and treatment services, infections are diagnosed later, transmission risks increase, and healthcare systems ultimately face higher costs.

Excluding migrants from healthcare does not protect public health; it undermines it. And yet, across Europe, barriers remain everywhere.

The scale of the issue is reflected in the latest ECDC data. In 2024, migrants accounted for more than 55% of new HIV diagnoses in the EU/EEA, up from 38.3% in 2015. Many migrants also acquire HIV after arriving in Europe, highlighting the need for accessible testing and prevention.

AHF Europe recently conducted a comparative analysis of migrants’ access to HIV and STI services across the nine European countries where AHF operates, including countries in both the EU and Eastern Europe. None fully guaranteed comprehensive access to care, and practical barriers including language, stigma, administrative requirements, and lack of information were identified across all countries reviewed.

Some countries have relatively strong legal frameworks on paper. But reality looks very different once someone tries to navigate the system. Can you access testing without health insurance? What documents do you need? Is interpretation available? Will seeking care affect your migration process? Can undocumented people safely access treatment? Who explains any of this?

These questions matter enormously in practice, and what we see repeatedly is that community organisations often become the bridge between migrants and healthcare systems that are difficult to navigate, even for citizens.

Across Europe, AHF supports community based and low threshold services, including checkpoints, multilingual testing, and outreach programmes that help migrants access care. These approaches are essential because healthcare is not only about services, but about trust. And right now, that trust is fragile.

That fragility risks becoming even worse under parts of the EU’s increasingly punitive migration agenda. Proposed changes to EU return and migration policies risk creating an environment where undocumented migrants become even more afraid to access healthcare services because of fears around surveillance, detention, deportation, or data sharing between institutions.

This is not a theoretical concern: when healthcare systems become entangled with migration enforcement, people disappear from care. Fear of detection pushes people further underground, weakening public health and eroding trust in healthcare systems, while placing healthcare workers in situations where medical ethics risk colliding with migration enforcement priorities. This is not just a migrant issue; it is a public health issue.

Taken together, this exposes a deeper contradiction in Europe’s current political direction. Since COVID-19, European leaders have repeatedly emphasised preparedness, resilience, and health security, highlighting the importance of early detection, strong public health systems, and rapid responses to infectious diseases. The EU has invested heavily in strengthening its health security architecture and improving preparedness for future pandemics. At the same time, however, parts of Europe’s migration policies risk pushing vulnerable communities further away from healthcare systems altogether.

Europe cannot claim to prioritise early detection and prevention while supporting policies that make people afraid to seek care. You cannot build resilient health systems while creating environments where undocumented people fear that visiting a clinic could expose them to detention or deportation. Europe should have learned this lesson already during COVID-19: health systems are only effective when people trust them enough to use them. If migrants avoid testing or treatment because healthcare systems are perceived as connected to migration enforcement, everyone becomes more vulnerable.

Across Europe, migration is increasingly discussed through the language of crisis and control. Health easily disappears in that political climate. Migrants are often portrayed as a burden on healthcare systems, even though excluding people from early prevention and care almost always creates worse health outcomes and higher long-term costs.

The solutions themselves are not particularly complex. We know what works: multilingual services, low threshold community testing, peer outreach, culturally competent care, and partnerships with civil society organisations. But these approaches require political commitment and sustained funding, not temporary pilot projects that disappear after two years.

The European Union has previously played an important role in coordinating HIV responses and setting common public health priorities. Renewing a strong EU HIV Action Plan, with a serious focus on migrant access and health equity, would be an important step forward.

Europe cannot seriously claim to pursue health equity while some of the most vulnerable people on the continent still face barriers to basic HIV and STI services. Migrant health is public health. When migrant health is neglected, public health fails us all.

Latin America: Access to HIV Care for migrants hindered by exclusionary policies

Migration and HIV: challenges to overcome barriers

Economic and political setbacks hinder access to public health services for the HIV-positive migrant population. .

“In many countries, access to HIV prevention and treatment services for trans women is impossible due to their immigration status, and this widens the health gap ” Latin American and Caribbean Network of Trans Women , speaking on the UNAIDS podcast Latin American Dialogues: Intersectionality in the HIV Response.”The network is an organization dedicated to defending the human rights of trans women, sex workers, and trans people in situations of human mobility and migration in Latin America and the Caribbean.

What Vidal says is a summary of the times. According to the UNAIDS program, it is estimated that between 30,000 and 40,000 people in transit in the region are living with HIV. The unprecedented social and economic crisis on the continent has generated the largest flow of refugees and migrants in history. In addition to their immigration status, they face high levels of stigma, xenophobia, and racism, and limited access to healthcare.

“We’ve had to receive colleagues who come with a diagnosis, a month of antiretroviral treatment, and when it ends, we practically have to force the health authorities to support us,” Vidal continues. “And what often happens is that because they don’t have identification, they can’t access treatment so easily. Sometimes adherence is lost because we’re talking about a month, a month and a half of waiting for treatment.”.

What’s missing

Bureaucracy, especially the requirement of identity documents in the health systems of host countries, acts as a tool of exclusion that prevents access to antiretroviral therapies and viral suppression controls.

The activists consulted for this article agree: the impact of HIV on people on the move is often exacerbated by institutional mistreatment, abandonment by families, and lack of support during transit, weakening their health . But they warn, “the response to HIV is weak for the entire population. It is not exclusive to the migrant population .

Deaths from advanced infection continue to be recorded in the region, where health systems are already strained. Barriers to accessing comprehensive and sustainable care exist. There is a lack of prevention models and medication shortages. All of this contributes to the virus not being detected in time.

Setbacks in the region

Countries like Costa Rica and Argentina, which historically led the LGBT+ rights agenda, are showing signs of regression in public policy. In Costa Rica, the withdrawal of the OAS LGBT working group and the halting of sexuality protocols in schools demonstrate this setback. Despite the existence of protective laws, their lack of regulation and a climate of discrimination persist. For example, a gender identity law is still lacking, and the restrictions faced by people with HIV, despite existing laws, do not fully protect them .

In Argentina, the National Front Against HIV, Hepatitis, and Tuberculosis reported a 76% reduction in funding allocated to HIV, hepatitis, tuberculosis, and STIs. The national government transferred the responsibility for purchasing antiretroviral drugs to the provinces without providing the necessary resources or logistical support, leading to medication shortages.

“The Milei government has cut the health budget specifically for everything related to HIV prevention and treatment. There are zero prevention campaigns and zero treatment campaigns. And shortages have begun. Before, the national government provided the medication to the different districts; now, the provision has become the responsibility of each district. Sometimes, districts find that these medications weren’t included in their budget allocations or that they lack the logistical capacity to purchase them; so they run out,” explains Mariano Ruiz, executive director of Human Rights and Diversity .

She adds: “The refugees we receive are mostly Russians or people from countries that were part of the Soviet bloc. The main reason they come to us is because they ran out of HIV medication . We help them by providing guidance before they arrive in the country because they are planning their departure from Russia, where life there is unsustainable. We ask them to find out their HIV status and to start treatment if they are positive. For these refugees, the biggest challenge in accessing healthcare is the language barrier,” she explains.

Barriers to access to health

The dismantling of public systems affects the migrant population. 27% of those seeking treatment arrive in an advanced stage of HIV . Furthermore, those in an irregular situation are 70% less likely to achieve viral suppression, according to UNAIDS data

In Mexico, the transition to the IMSS-Bienestar model (a program to provide free medical care to people without social security) has created administrative barriers that violate the right to life of both migrants and internally displaced persons. The requirement of the CURP (a national identification document) is the main obstacle to accessing medications at CAPASITS (Outpatient Centers for the Prevention and Care of AIDS and Sexually Transmitted Infections, which are free, specialized health units in Mexico).

Brigitte Baltazar Lujano, coordinator of the LGBTQ+ community program at the organization Al Otro Lado in Tijuana, points out the seriousness of these omissions.

“It’s not only the external migrant population that is suffering these devastating effects. The involuntary migrant community, internally displaced persons, are also affected. Recently, there have been many changes in how the government handles health issues. It is more difficult for internally displaced persons to access their HIV medication. For people from other countries, it is twice as difficult to access these medications. This represents a very serious lack of attention from our country in this sector. The right to access medication or any other type of medical care that any human being may have is being violated.”

PrEP is not guaranteed for migrant populations

Pre-exposure prophylaxis (PrEP) is a vital prevention tool for migrant populations. However, access to PrEP and emergency post-exposure prophylaxis (PEP) is limited by bureaucratic barriers and discrimination.

In Tijuana, access for migrants is practically nonexistent because the medication is strictly controlled by the Ambulatory Centers for the Prevention and Care of AIDS and Sexually Transmitted Infections (CAPASITS), and identification is required to obtain it, explains Brigitte Baltazar. This same requirement for identification exists in Costa Rica.

“If a migrant arrives after being sexually abused, the health system’s response is usually, ‘Wait three months, get tested, and if you test positive, then we’ll start antiretroviral medication.’ This adds to all the bureaucracy involved in starting treatment. In other words, there is no emergency PEP available for undocumented people, and that leaves them at absolute risk ,” Brigitte explains.

In Argentina, the situation is similar for both asylum seekers and Argentinians seeking emergency medication. “The main obstacle for asylum seekers is the language barrier. Then there are all the same challenges faced by Argentinians: the lack of medication, and sometimes refusal from healthcare staff who are trying to conserve resources. It’s left to the doctor’s discretion whether they consider the person seeking it to have risky behaviors, even though, according to legislation, PrEP is a prevention strategy available only at the person’s request,” explains Mariano Ruiz.

Lack of funding and anti-immigrant policies

The region is also facing cuts in international cooperation. The withdrawal of funding from USAID , the Global Fund, and the closure of UNAIDS offices have left civil society organizations working on HIV, migration, LGBT+ rights, and other issues in a precarious situation.

“I find it so irresponsible and also very perverse that these cuts are eliminating programs when we know they did produce results and did save lives. This continues to be alarming and worrying,” says Dennis Castillo, executive director of the Institute on LGBT Migration and Refugees for Central America (IRCA Casabierta), an organization based in San José, Costa Rica.

Adding to the financial hardship are anti-immigrant rhetoric and policies. Mario Campos explains that migrants living with HIV in the United States fear deportation when seeking healthcare, and that is reason enough not to seek medical attention.

In everyday life, the stigma also manifests itself in the mistreatment by administrative and security staff in hospitals, even before they receive care. “From the moment migrants arrive at the hospital, it’s the security guard who asks which department they’re going to or their medical condition. People already feel uncomfortable and vulnerable. Once, someone told me that the guard said, ‘That’s why you have to be careful, that’s why you shouldn’t be having reckless sex.’ The stigma and discrimination that migrants suffer is serious, but if you add living with HIV, it’s extremely serious ,” says Brigitte Baltazar from Tijuana.

The community response in Mexico, Costa Rica, Argentina and the United States

Faced with the abandonment by States, grassroots organizations and independent activists have assumed the responsibility of guaranteeing services that governments omit, such as prevention campaigns, screening tests and the supply of medication.

In Mexico, the organization Al Otro Lado combats the exclusion caused by the CURP requirement by providing legal support and a physical presence in hospitals to ensure that migrants and internally displaced persons living with HIV can access services and are not discriminated against. They also manage online registrations, provide transportation, and have established partnerships with the AHF Healthcare Foundationto obtain emergency doses of medication when the government denies them.

“The Mexican State must provide what is rightfully theirs, which is access to healthcare for all people. It is a historical debt that the government owes to the migrant population to receive them and provide them with the services they are legally entitled to,” Brigitte Baltazar reiterates.

In Costa Rica, IRCA Casabierta offers a comprehensive approach that includes legal and psychological assistance, a food bank, and a computer lab for the digital regularization of migrants. Faced with cuts in international funding, the organization manages state resources to purchase preventative supplies that the health system does not provide to uninsured individuals. Dennis Castillo, executive director of IRCA Casabierta, denounces the Costa Rican government for abandoning prevention efforts, delegating this task to civil society.

In Argentina, the organization Human Rights and Diversity runs an integration center for LGBTQ+ refugees, most of whom come from Russia, Belarus, and Georgia. Due to a lack of government support to overcome administrative and language barriers, they use “social interpreters”—former beneficiaries who speak the language—to accompany patients to their medical appointments.

Activist Mario Campos connects people on the move with free clinics in Mexico, the United States, Canada, and Spain. His work focuses on combating the knowledge gap caused by the lack of comprehensive sex education, especially among migrants from Central American countries, primarily Guatemala, El Salvador, and Honduras. Mario believes that misinformation and the lack of comprehensive sex education are critical barriers that increase the vulnerability of people living with HIV.

India: Mobility hampers HIV treatment follow-up among migrant labourers in Kerala

HIV cases in Perumbavoor guest workers

Kochi: After a rise in drug-related issues sparked tensions between locals and migrant labourers in Perumbavoor, there is now concern about health department’s difficulty in tracking guest workers, who tested positive for HIV in the last few months, and provide them with treatment. Wrong mobile numbers and addresses and frequent movement within the state due to the nature of work pose hurdles in tracking them.

Health department decided to conduct a field visit to Perumbavoor and Kerala State Aids Control Society (KSACS) will convene a meeting with govt departments such as police, excise, labour and local bodies to chalk out a plan to address the issue.

Data with health department shows that about 26% of those who tested HIV-positive in Perumbavoor area in the past few months were guest workers. The random testing was conducted through Perumbavoor taluk hospital.

Although the department is reluctant to share the total number of people tested and how many turned positive, officials said their real concern was migrant labour. The percentage may not appear alarming, as migrant labour testing HIV-positive is only 1/4th the total number of people who tested positive in Perumbavoor. However, the real worry is different: the migrant population is floating, and health officials are concerned because they are unable to trace many HIV-positive guest workers. Hence, timely intervention has become difficult.

Health officials realised that in most cases, the addresses provided are fake, making it difficult to track them in their home state too. “We are compiling data regarding all HIV cases in the area, including the latest test results,” said a KSACS official.

“By the time we get detailed test results, we fear the infected guest worker would leave here. Attempts to trace them using the phone numbers or address given by them often reach a dead end. We learned that some of them even possess multiple Aadhaar cards,” he added.

Even if addresses are genuine, tracking them isn’t easy. “Their mobility makes it difficult to trace them. Due to the nature of their work, they move from one place to another within days. In some cases, they leave the state. In such cases, we have to seek the support of National Aids Control Organization (NACO),” said another KSACS official.

Although state govt instructed labour and home departments to prepare a registry of guest workers more than four years ago, the work remains incomplete. Labour department was supposed to issue digital ID cards through Athithi portal, but the process is still halfway. Local bodies and health departments are supposed to conduct inspections at the accommodation facilities of guest workers, but they rarely do it.

Health department plans to seek district administration’s support for coordination with various govt departments in the district. The plan is to assign specific targets for each department.

 

Netherlands: New study links migration and poverty to HIV risk

Immigration and poverty tied to heightened HIV risk in the Netherlands

There is a strong social gradient associated with HIV diagnoses in the Netherlands, Dr Vita Jongen from Stichting HIV Monitoring and colleagues report in The Lancet Regional Health – Europe. People who are poorer or are first-generation immigrants are much more likely to be diagnosed with HIV, while intersections between poverty and migration further increase their vulnerability.

Background

The Netherlands has nearly reached the UNAIDS 95-95-95 targets: 95% of people with HIV are diagnosed, 95% of those diagnosed are on treatment and 95% of those on treatment are virally suppressed. Additionally, access to HIV pre-exposure prophylaxis (PrEP) has dramatically reduced HIV transmission, particularly among younger people.

While new HIV diagnoses dropped consistently throughout the 2010s, they’ve stabilised since 2020, at around approximately 500 a year. Gay, bisexual and other men who have sex with men make up around 60% of these new diagnoses, other men around 20%, women around 16% and trans people around 4%.

However, gaps remain – especially for groups such as women and cisgender straight men. Across Europe, there are gaps in coverage of HIV prevention and treatment for migrants. Migrants often lack in-depth knowledge of how to navigate the health system in a new country and may find that language barriers make access to HIV services a challenge.

At a time of decreasing HIV incidence across Europe, when some groups are disproportionately affected by new diagnoses, researchers are interested in the structural and social factors that may make certain people more vulnerable to acquiring HIV. Here, the focus isn’t on risk groups and sexual behaviours – as has been the focus for most of the epidemic – but instead on broader factors, such as poverty or immigration status, and how these cluster together and intersect to create unique and emerging HIV vulnerabilities.

The study

HIV care in the Netherlands is provided by 23 treatment centres who contribute data to the centralised Stichting HIV Monitoring. While the Netherlands has universal healthcare, this is based on mandatory private insurance contributions. HIV testing is free for specific populations, such as gay men and trans women. Documented migrants have access to the healthcare system, but undocumented migrants may have to pay out of pocket for health-related services. However, any care deemed medically necessary – such as HIV testing and care – should not be withheld, even for undocumented people.

Over 97% of all people living with HIV in the Netherlands also contribute their data to a research cohort, AIDS Therapy Evaluation in the Netherlands (ATHENA). This is one of the main data sources for the current study.

Additionally, researchers accessed data from Statistics Netherlands for two purposes. The first was to perform comparisons between age and sex-matched individuals in the general population and people diagnosed with HIV. The second was to match HIV diagnosis data with specific individuals represented in Statistics Netherlands data, to investigate potential associations between being diagnosed with HIV and education, income, immigration status and certain health behaviours, such as using mental healthcare services or antidepressant medication. This was done by matching an individual’s date of birth, the first four digits of the postal code of their last known residence and sex at birth. This allowed for linkage between ATHENA and Statistics Netherlands data. If exact matching was not possible, the data was not used for the results.

All people in the ATHENA cohort over 18 and newly diagnosed with HIV in the Netherlands between January 2012 and December 2023 were included. People who migrated to the Netherlands with known HIV were excluded, as were transgender people – due to small numbers and the possible risk of identification.

Intersecting factors create unique vulnerabilities to HIV

For the study period, 6055 men and 1020 women were newly diagnosed with HIV. Most people diagnosed with HIV were aged between 25 and 49 years old – 64% of all diagnoses for both men and women, with very few diagnoses among those aged 18 to 25. The 25-to-49-year-old group was overrepresented when compared to the general Dutch population, where they comprised 44% of all men and 49% of all women.

Of men diagnosed with HIV, most were neither first- or second-generation immigrants (59%), a large proportion had secondary education or higher (41%) and fell into the middle-to-low-income bracket (43%). However, when compared with the general population, there were many more immigrants among those diagnosed with HIV than generally (40% vs. 23%) and more men living below the poverty line among those diagnosed with HIV (23% vs. 12%). There were also sizable differences in those who used mental health care services and antidepressants among those diagnosed with HIV and the general population (7% vs. 5% and 8% vs. 5%, respectively).

Of women diagnosed with HIV, most were first-generation immigrants (55%), a large proportion had mainly primary and secondary education (44%) and their income fell below the poverty line (45%). Moreover, when compared with the general population, there were many more immigrants among those diagnosed with HIV than generally (64% vs. 25%) and there more women living below the poverty line among those diagnosed with HIV (45% vs. 14%). There was a notable difference in those who used antipsychotic medications among people diagnosed with HIV and the general population (5% vs. 2%).

When considering specific socio-economic categories and health behaviours, first-generation immigrant men were over twice as likely to be diagnosed with HIV than non-immigrants (adjusted Odds Ratio 2.21, 95% Confidence Interval 2.08-2.35). This pattern was much stronger for first-generation immigrant women, who were over four times more likely to be diagnosed with HIV than non-immigrant women (aOR 4.48, 95% CI 3.87-5.19). Statistically significant increases in HIV diagnoses still held true for second-generation immigrants but were not as pronounced, as these people were born in the Netherlands and likely have better healthcare knowledge and access.

The most notable difference for both women and men related to income: women living below the poverty line were over four times more likely to be diagnosed with HIV than high-income women (aOR 4.71, 95% CI 3.8-5.83), while women in the middle to low-income bracket were nearly two and a half times more likely to be diagnosed with HIV than high income women (aOR 2.49, 95% CI 2.05-3.01). For men, this difference was not as dramatic – men living below the poverty line were nearly twice as likely to be diagnosed with HIV than high-income men (aOR 1.75, 95% CI 1.62-1.89). The poverty line is defined as household income less than 120% of the social minimum, or income needed to survive.

Interestingly, men who used antidepressants were more likely to be diagnosed with HIV than those who did not; for women, antipsychotic medications were more likely to be associated with an HIV diagnosis.

When considering combined demographic, socio-economic and health behaviour factors, certain profiles were more likely to have a predicted risk of being diagnosed with HIV than others. A first-generation immigrant man aged 25 to 49, with income below the poverty line and using antidepressants, would have a 12-fold higher risk of being diagnosed with HIV than a man older than 50, with no immigration history and a high income. Similarly, a first-generation immigrant woman aged 25 to 49, with income below the poverty line, receiving social welfare, and using antipsychotic medications, would have a much higher predicted risk of being diagnosed with HIV than women with differing profiles.

Conclusion

“A disproportionally higher burden of new HIV diagnoses was observed for individuals with not only a migration background, but also economic and mental health vulnerabilities,” the authors conclude. “Barriers to HIV prevention and testing need to be reduced if we are to achieve no new HIV infections and end the HIV epidemic.”

This research is a clear indication of the social gradient: those who are poorer and experience the worst consequences of migration, such as first-generation immigrants, are much more likely to see worse health outcomes, such as being diagnosed with HIV. These negative health consequences ease off for low-to-middle income people and second-generation immigrants but are still visible – even in settings with access to HIV testing and prevention.

Intersections between factors such as poverty and migration heighten HIV vulnerability and need to be adequately and actively acknowledged by any public health policies aimed at eliminating new cases of HIV.

References

Jongen VW et al. Risk of new HIV diagnosis by intersecting migration, socioeconomic, and mental health vulnerabilities in the Netherlands: a nationwide analysis of the ATHENA cohort and Statistics Netherlands registry data. The Lancet Regional Health – Europe, 60: 101508, 2026 (open access).

https://doi.org/10.1016/j.lanepe.2025.101508

Spain: Regularisation of migrants expected to improve HIV diagnosis and prevention

AI translation – Scroll down for article in Spanish

Cesida emphasizes that the extraordinary regularization of migrants will improve their real access to public health

The State Coordinator of HIV and AIDS (Cesida) has applauded the implementation of the procedures for an extraordinary administrative regularization that will affect more than half a million migrants living in Spain. The organization believes that this measure will allow real access to the health system and will help leave behind a situation of structural exclusion with a direct impact on their health and quality of life.

Cesida highlights the relevance of this initiative in the context of the response to the human immunodeficiency virus (HIV). Ordinary access to health makes it possible to advance in the diagnosis, treatment and implementation of combined prevention strategies, including pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP).

The entity has insisted that a health system that aspires to be truly universal must prioritize care for people in the most vulnerable situations, including those at high risk of acquiring HIV.

In this line, Cesida stressed that administrative exclusion not only implies a violation of rights, but also weakens public health policies and the capacity for collective response to the epidemic.

The Venezuelan migrant with HIV and member of the Cesida executive Jesús Cisneros has valued the positive impact of regularization for “all these people who have found themselves for years working in a submerged economy and living in a rather precarious way.”

Likewise, he has asked to continue advancing rules of this type and speed up administrative procedures, since, as he has pointed out, these people come to Spain on many occasions “because their life depends on it, they depend on HIV medication to continue living.”

The Cesida entities that work with the migrant population have already been activated to support the management of this regularization, providing information, social support and legal advice to people who may benefit from the process.

The State Coordinator of HIV and AIDS has also demanded to pay attention to the administrative deadlines and requirements that continue to condition access to health care. Specifically, he pointed out that the times linked to registration, whose resolution period can be extended up to three months, continue to be an element that can significantly delay effective access to health.

Cesida subraya que la regularización extraordinaria de migrantes mejorará su acceso real a la sanidad pública

La Coordinadora Estatal de VIH y sida (Cesida) ha aplaudido la puesta en marcha de los trámites para una regularización administrativa extraordinaria que afectará a más de medio millón de personas migrantes residentes en España. La organización considera que esta medida permitirá un acceso real al sistema sanitario y ayudará a dejar atrás una situación de exclusión estructural con impacto directo en su salud y en su calidad de vida.

Desde Cesida se remarca la relevancia de esta iniciativa en el marco de la respuesta frente al virus de la inmunodeficiencia humana (VIH). El acceso ordinario a la sanidad posibilita avanzar en el diagnóstico, el tratamiento y la implementación de estrategias de prevención combinada, entre ellas la profilaxis preexposición (PrEP) y la profilaxis posexposición (PEP).

La entidad ha insistido en que un sistema sanitario que aspire a ser verdaderamente universal debe priorizar la atención a las personas en situación de mayor vulnerabilidad, incluidas aquellas con un riesgo elevado de adquirir el VIH.

En esta línea, Cesida ha recalcado que la exclusión administrativa no solo implica una vulneración de derechos, sino que también debilita las políticas de salud pública y la capacidad de respuesta colectiva ante la epidemia.

El migrante venezolano con VIH y miembro de la ejecutiva de Cesida Jesús Cisneros ha puesto en valor el impacto positivo de la regularización para “todas estas personas que se han encontrado durante años trabajando en una economía sumergida y viviendo de una manera bastante precaria”.

Asimismo, ha pedido seguir avanzando en normas de este tipo y acelerar los procedimientos administrativos, ya que, tal y como ha señalado, estas personas llegan a España en muchas ocasiones “porque su vida depende de ello, dependen de la medicación del VIH para seguir viviendo”.

Las entidades de Cesida que trabajan con población migrante ya se han activado para apoyar la gestión de esta regularización, proporcionando información, acompañamiento social y asesoramiento jurídico a las personas que puedan verse beneficiadas por el proceso.

La Coordinadora Estatal de VIH y sida ha reclamado además prestar atención a los plazos y requisitos administrativos que continúan condicionando el acceso a la atención sanitaria. En concreto, ha señalado que los tiempos vinculados al empadronamiento, cuyo plazo de resolución puede alargarse hasta tres meses, siguen siendo un elemento que puede demorar de forma notable el acceso efectivo a la salud.

Russia: List of diseases for which labour migrants are tested expand to include hepatitis B and C

Migrants arriving in Russia will be examined for hepatitis B, C and D in 2026.

The Ministry of Health has already prepared amendments to the order on medical examination of foreigners, now its draft is under approval, said Natalia Pakskina, Deputy Director of the Department of Emergency Medical Care Organization and Health Risk Management of the Ministry of Health of Russia.

“We are, by and large, on the finish line. We have included just a medical examination of foreigners for hepatitis B and C, including with a delta agent (hepatitis D). Therefore, we will examine foreigners from the same year,”
– Pakskina reported.

Earlier, a bill was submitted to the State Duma, which involves migrants to undergo medical examinations within 30 days from the date of entry into Russia. Now this period is 90 days.
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Прибывающих в Россию мигрантов в 2026 году начнут обследовать на гепатиты B, C и D.

Минздрав уже подготовил изменения в приказ о медицинском освидетельствовании иностранцев, сейчас его проект на согласовании, рассказала замдиректора департамента организации экстренной медицинской помощи и управления рисками здоровью Минздрава России Наталья Пакскина.

«Мы, по большому счету, на финишной прямой. Мы включили как раз медицинское обследование иностранцев на гепатиты В и С, в том числе с дельта-агентом (гепатит D). Поэтому обследовать иностранцев мы будем с этого же года»,
— сообщила Пакскина.
Ранее в Госдуму внесли законопроект, предполагающий прохождение мигрантами медосвидетельствования в течение 30 дней с момента въезда в Россию. Сейчас этот срок составляет 90 дней.
Источник: https://moika78.ru/news/2026-01-28/1254506-v-rossii-nachnut-proveryat-migrantov-na-gepatity-v-s-i-d