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

Jonathan Ross, Matthew J. Akiyama, Deepika Slawek, Jennifer Stella, Kim Nichols, Mulusew Bekele, Chinazo O. Cunningham, Oni J. Blackstock

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)336-341
Number of pages6
JournalAIDS Patient Care and STDs
Issue number7
StatePublished - Jul 1 2019


  • African immigrants
  • HIV
  • HIV testing
  • linkage to care
  • undocumented immigrants

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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