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Why migrants living with HIV must be part of the solution to improving HIV health outcomes among those born abroad


By Charity Nyirenda

Migrants living with HIV must be involved in research and initiatives wanting to understand and improve HIV health outcomes among people born abroad. This is why I was so pleased to be appointed as a Peer Expert to work with National AIDS Trust on the HIV and migration report, published a week ago today.

As a member of the research team, I worked alongside other Peer Experts, all of us born abroad and living with HIV, to recruit and interview migrants living with HIV in the UK about their experiences. We wanted to get a better understanding of the barriers they face accessing HIV testing, treatment and care here.

The interviews I conducted were moving, powerful and familiar. Our shared experience meant I had an instant rapport with the participants and so I could provide a safe and secure space for people to share with me their experiences. I was honoured they trusted me.

I was fortunate to be able to play an invaluable role in this report. Unfortunately, the restrictions on the right to work for many migrants in the UK mean that it’s difficult to involve migrants in research and initiatives to improve HIV health outcomes.

Despite arriving in the UK in 1995, I wasn’t granted leave to remain until 2017. I waited 12 long years for the Home Office to make a decision on my immigration application. During this period, my life was static; I was prohibited from working, claiming benefits, and studying. I rarely had reason to leave the house to distract myself from my situation so I had poor mental health. I decided to use my time volunteering in the HIV sector, participating in campaigns to increase awareness of HIV in my community and supporting culturally-specific HIV support services in London. However, with no income and having no recourse to public funds, my life was far from easy. It was a challenge just to survive; to find shelter, to attend all clinic appointments, to continue reporting to the Home Office. I regularly had to ask friends for bread and milk.

I was diagnosed with HIV in 2003, and I know first-hand how restrictions on the right to work also affect the health and quality of life of migrants living with HIV. Poverty forces people into situations more likely to put them at risk of acquiring HIV and makes it harder for them to engage with care and access effective treatment to stay healthy once living with HIV. I empathised with the people I interviewed who told me how hard they found it to survive without a job, struggling to afford a bus to go to an appointment at the HIV clinic or being sick and having no food to eat. Since I was granted immigration status, I’ve been fortunate enough to find some work and study, but that period of my life continues to haunt me as most jobs require work experience which I simply don’t have.

There’s little understanding of the impact of the current lack of permission to work and No Recourse to Public Funds policy. This is why our report recommends the Health and Social Care Committee should investigate the health and economic impacts of these policies on individual and public health.

At every level, migrants living with HIV should be a part of the solution. As well as alleviating financial hardship, lifting restrictions on the right to work would enable us to more easily contribute in a paid capacity to the HIV sector. HIV prevention campaigns and initiatives must be targeted at migrants and should be co-designed with the community. Our involvement is crucial if we want to end new cases of HIV by 2030.

Charity Nyirenda is a Peer Expert for National AIDS Trust

HIV and migration: Understanding the barriers faced by people born abroad living with HIV in the UK, National AIDS Trust, June 2021, http://bit.ly/HIVandMigration

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