5 things I learned from my research on HIV among immigrants

December 1st is world AIDS day – a day marked across the globe to spread awareness of HIV/AIDS. Whenever I told people about my research project while I was doing my masters, I was met with great surprise. My thesis explored HIV treatment outcomes among immigrants and refugees living with HIV here in Manitoba, Canada. So many people, especially immigrants, seemed surprised that HIV was something of concern here let alone that it affects communities in Canada.

It’s no surprise though – especially when you are coming from countries where information about HIV is everywhere – on billboards, infomercials, posters, then moving to a country where awareness is minimal. This lack of visible information may be interpreted as a sign that it’s not of concern.

However, in North America, there are several key populations that are disproportionately  affected by HIV. In Canada, African, Caribbean and Black (ACB) communities, have an infection rate that is six times higher than other Canadians. Other key populations that experience significantly higher rates of HIV include men who have sex with men (MSM), people who inject drugs, sex workers, and Indigenous people.

So here are 5 things I learned during my research

1. A diagnosis of HIV can affect immigration visas

As part of the immigration process, people immigrating to Canada (including some visitors and international students) may undergo an immigration medical exam that screens for health conditions including HIV. In Canada, since healthcare is publicly funded,  having a diagnosis of HIV may mean that you can be denied a visa, as the health cost associated with having HIV may be much more compared to the average cost of healthcare for the average Canadian. This is referred to as being “medically inadmissible” to the country and could be a result of various medical conditions not just HIV.  However, refugees, spouses of citizens and residents, and dependent children cannot be denied visas based on health conditions that result in excessive medical costs.

2. HIV is a nationally notifiable disease

HIV in Canada and the US is notifiable meaning that all cases are reported to Public Health for surveillance. In Canada specifically, public health authorities must follow up to ensure you are aware of your diagnosis, you are connected to HIV care, and your contacts are notified to go for testing (people who you had sex with or shared drug injection equipment).

3. You are legally obligated to notify your sexual partners in some instances

If you are living with HIV in Canada, you are legally obligated to notify all your sexual partners prior, regarding your status. The only time you are not legally required to disclose is when your HIV viral load is low (virally suppressed as a result of being consistently on HIV treatment) AND you use a condom. In the US, HIV-specific criminal exposure laws vary widely and vary state by state. Criminalization of HIV non-disclosure remains a very polarizing issue and some people living with HIV have been charged with aggravated sexual assault by failing to disclose their status.   

4. PrEP is available for prevention to people at high risk of acquiring HIV

Pre-Exposure Prophylaxis (PrEP) is a way for an HIV-negative person at risk of HIV infection to reduce their risk of acquiring HIV. Depending on where you are in Canada, PrEP may be covered by the province, or through private insurance.

5. HIV-related stigma is common among immigrant communities

HIV stigma among immigrant communities remains a huge barrier for people to access testing, seek treatment, care and support. Stigma and discrimination has resulted in immigrants being diagnosed at later stages of the disease, meaning they are more sick at diagnosis with damage to the immune system leading to AIDS defining illnesses. Early diagnosis of HIV is key to successful treatment.

We need to start speaking openly about HIV in the diaspora, engage in conversations that promote HIV awareness and understanding in order to curb the epidemic.

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2 thoughts on “5 things I learned from my research on HIV among immigrants

    1. I read that it takes about 3 to 6 months after starting treatment and taking medication daily. After the first viral load test that shows the virus is undetectable, one needs to maintain this for 6 months for the virus to be considered suppressed.

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