HIV and migration: Two major uncertainties for people from culturally and linguistically diverse backgrounds

Objective: To describe the interrelationship between living with HIV, migrating to andresettling in a new country, and the Australian migration system.Method: Key issues from the international literature on HIV-positive ethnic minorities inresource-rich countries are summarised. Findings are presented from semi-structured, in-depth interviews with clients of the Multicultural HIV/AIDS and Hepatitis C Service, and a sexual health clinic, both in Sydney.Results: Three major themes interwoven with migration were identified: HIV diagnosis, access to care and support, and forming social relations. Participants who applied for permanent residency in Australia, rather than off-shore, were usually diagnosed by means of the HIV-test that is part of the health requirement for permanent residents. This jeopardised their prospect of staying in Australia and was at the same time a barrier to returning to their country of birth. It was also a major barrier to accessing health care and support services and a major source of uncertainty. Because of the stigma associated with HIV/AIDS, many had little or no contact with their ethnic communities. At the same time, they found it difficult to form new social relationsin the English-speaking mainstream culture. A further problem was feeling torn between Australia and the promise of a better future, and the close emotional relationships with family and friends in the country of birth.Conclusion: New migrants with HIV need to negotiate simultaneously two major lifedisruptions and two major uncertainties: migration and HIV infection. In the Anglo-Celticmainstream, language, cultural and financial barriers to health and support services should be removed or minimised. In ethnic communities, HIV-related stigma needs to be addressed to enable new migrants to rebuild social relations with these communities and to rebuild their lives