AIDS Patient Care and STDs
Volume 33, Issue 7, 2019, Pages 336-341

Undocumented African Immigrants' Experiences of HIV Testing and Linkage to Care (Article)

Ross J.* , Akiyama M.J. , Slawek D. , Stella J. , Nichols K. , Bekele M. , Cunningham C.O. , Blackstock O.J.
  • a Division of General Internal Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 3300 Kossuth Avenue, Bronx, NY 10463, United States
  • b Division of General Internal Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 3300 Kossuth Avenue, Bronx, NY 10463, United States
  • c Division of General Internal Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 3300 Kossuth Avenue, Bronx, NY 10463, United States
  • d Division of Hospital Medicine, Zuckerberg San Francisco General, University of California, San Francisco, San Francisco, CA, United States
  • e African Services Committee, New York, NY, United States
  • f African Services Committee, New York, NY, United States
  • g Division of General Internal Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 3300 Kossuth Avenue, Bronx, NY 10463, United States
  • h New York City Department of Health and Mental Hygiene, New York, NY, United States

Abstract

In the United States, undocumented African immigrants living with HIV enter care late, potentially leading to adverse individual and population health outcomes, yet little is known about the specific experiences of HIV diagnosis and linkage to care among this population. We conducted individual, semi-structured interviews with adults who were undocumented African immigrants living with HIV in New York City. Interviews explored perspectives regarding individual, social, institutional, and societal barriers and facilitators of HIV testing and linkage to care. Of 14 participants from 9 different African countries, 9 were women and the median age was 44 years (interquartile range: 42-50). Participants described fear of discovery by immigration authorities as a substantial barrier to HIV testing and linking to initial medical appointments. Actual and perceived structural barriers to both testing and care linkage included difficulty obtaining health insurance and a belief that undocumented immigrants are ineligible for any health services. Participants also expressed reluctance to be tested because of HIV-related stigma within the immigrant communities that they heavily relied on. After diagnosis, however, participants overwhelmingly described a positive role of health and social service providers in facilitating linkage to HIV care. Concerns about immigration status and HIV-related stigma are significant barriers to HIV testing and linkage to care among undocumented African immigrants. Multilevel efforts to reduce stigma and increase awareness of available services could enhance rates of HIV testing and care linkage in this population. © Copyright 2019, Mary Ann Liebert, Inc., publishers 2019.

Author Keywords

linkage to care HIV testing Undocumented immigrants HIV African immigrants

Index Keywords

personal experience immigrant Human immunodeficiency virus infection population health health insurance human social isolation health service African Social Work qualitative research United States undocumented immigrant male semi structured interview female clinical article stigma Article health care adult preventive medicine
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85068340476&doi=10.1089%2fapc.2019.0036&partnerID=40&md5=601cc66cd551be01062f00a516ccdb4d
DOI: 10.1089/apc.2019.0036
ISSN: 10872914
Original Language: English