Systemic Barriers Impede HIV Care for African MigrantsSystemic barriers and policy hurdles block HIV care for African migrants

A narrative review highlights the considerable systemic barriers that African migrants living with HIV face in accessing care. These barriers are driven by restrictive immigration policies, fragmented and exclusionary health financing, and intersecting stigmas, including racism, xenophobia, HIV stigma, and homophobia. Inconsistent provider competencies further compound these challenges, leading to disparities in health outcomes.

The review synthesizes peer-reviewed and grey literature to identify how legal, policy, and socio-structural factors shape access to HIV care. It emphasizes that these barriers are not isolated but interconnected, creating a complex web that migrants must navigate. The findings underscore the need for comprehensive, rights-based approaches to address the root causes of inequity.

To align policy and practice with human rights obligations, the review proposes seven strategies. These include decoupling healthcare from immigration enforcement, ensuring health financing is inclusive of all migrants regardless of status, and developing migrant-inclusive health information systems. Such measures aim to reduce stigma and improve access to continuous, quality care.

The review also calls for enhancing provider competencies through training and support, fostering trust between migrants and healthcare systems, and promoting community engagement. By addressing these systemic factors, it is possible to move toward health equity for this population.

While the review provides valuable insights, it is a narrative synthesis rather than a primary clinical trial. Therefore, its conclusions should be interpreted with caution, but they offer a critical framework for policy and practice changes.