Dr Will Nutland Discusses Enhanced Outreach to Queer Migrant Men Living With HIV in London

Queer migrant men living with HIV in London encounter several issues beyond treatment access that men born in the United Kingdom do not; chief among these is fear of deportation and not being able to pay for their treatment, whether that be for HIV or a sexually transmitted infection (STI), discussed Will Nutland, DrPH, cofounder of PrEPster, honorary assistant professor at the London School of Hygiene and Tropical Medicine, and an activist.

Transcript

How do you address PrEP disparities among queer migrant men, and do they face additional concerns beyond treatment access?

We actually have a dedicated project that we’re working on this year to try and better reach queer migrant men in London around PrEP [preexposure prophylaxis] access, access to sexual health services. There are a couple of things that we are absolutely banging up against with these guys.

The first is lots of the guys don’t know that National Health Service [NHS] sexual health services are free for absolutely everyone regardless of your immigration status. If someone from the States rocked up in London for 2 weeks and decided that they needed an STI screen, they could actually go to any sexual health clinic and get that for free, and if they test positive for an STI and HIV, they can get the treatment for free. This is something we’re immensely proud of. Despite other policies that our government have brought in that many of us aren’t proud of, this is one that was brought in that we know we would fight tooth and nail to hold on to; it’s something to be very proud of.

But we’re finding that these queer migrant men didn’t know that. They thought that if they rocked up at a clinic and they test positive for something, they’re not going to be able to pay the treatment costs, or they’re going to end up with a great big bill, or they’re going to have to pay for PrEP, or if they test positive for HIV, they’re going to have to pay for their treatments. So one of the things we’re doing is really kind of getting out there and talking to these guys and helping them to navigate these services.

Secondly, we know that lots of these guys, many of them don’t have English as a first language and don’t necessarily have particularly brilliant written or spoken English. So we are making sure that we’ve employed a staff team and a bunch of volunteers who speak as many languages as possible.

The final thing that is the big concern for these guys is that they don’t want to access health services—not just sexual health services, but health services—because some of them are scared that their information won’t be held confidentially or that they will be reported to the Home Office if they don't have secure immigration status and they will be deported. Again, this is not the case. Our NHS sexual health services cannot pass an individual’s information on to them without their permission. That’s another part of the things that we’re trying to get across in the project.

This is kind of the long way of saying that if you look at men who have sex with men, there are also massive health inequalities at play, because of fears around migration, because of racism, because of stigma, because of homophobia. There are a number of projects, including the work that we do at PrEPster and The Love Tank, which is our parent company, that are really trying to get out there and speak to people and help them navigate their fears around accessing PrEP and other sexual health services.