Immigrants and HIV
Know Your Rights. Find Your Care.

You Have the Right to Care

If you are living with HIV in the United States, you are eligible for HIV testing, treatment, and support services — regardless of your immigration status. This is not a gray area. Federal programs that fund HIV care, including the Ryan White HIV/AIDS Program^[1] and community health centers, determine eligibility based on your HIV status and income, not your citizenship or documentation. HRSA Policy Clarification Notice 21-02 states plainly that immigration status is irrelevant for Ryan White eligibility.^[2]

That means whether you are a U.S. citizen, a green card holder, a refugee, an asylum seeker, a visa holder, a DACA recipient, or undocumented, you can access HIV care. You do not need a Social Security number. You do not need insurance. You do not need to show a passport or immigration documents. And your healthcare providers are not immigration enforcement agents — they are bound by federal privacy laws to protect your information, and HRSA guidance directs Ryan White programs not to share client immigration status with immigration enforcement.

The Ryan White HIV/AIDS Program

The Ryan White HIV/AIDS Program is the largest federal program specifically dedicated to HIV care. It funds clinics, medications, case management, transportation, mental health services, and more across every state and territory. It was designed to fill the gaps that other programs do not cover — and for immigrants, it is often the single most important source of care.

Eligibility comes down to two things: a documented HIV diagnosis and income below the jurisdiction's threshold (typically 300 to 400 percent of the federal poverty level). No citizenship requirement. No immigration status check. No Social Security number needed. HRSA PCN 21-02 makes this explicit and instructs Ryan White programs not to share client immigration status with immigration enforcement.^[2]

The program covers a wide range of services: primary HIV medical care, antiretroviral medication through ADAP (the AIDS Drug Assistance Program), dental care, mental health and substance-use treatment, case management, transportation, and emergency financial help. HRSA data show the program serves more than half a million people nationally each year — a substantial share of whom are uninsured — making it the largest single source of HIV care in the country.^[4]

If you are an immigrant living with HIV and you do not know where to start, a Ryan White-funded clinic is the best first step. A case manager at these clinics can help you navigate every other service you may need. Use our Care Locator to find one near you.

Overcoming Fear

Fear is the single greatest barrier to care for immigrants living with HIV. Not the virus. Not the cost. Not the distance to a clinic. Fear.

Fear of being reported to immigration authorities. Fear that seeking care will hurt an immigration application. Fear that a hospital visit will lead to deportation. Fear of being seen walking into an HIV clinic in a small community. Fear that a diagnosis will follow you across borders. These fears are real, they are deeply felt, and policy changes at both the state and federal level are making them worse.

The Public Charge Rule

The public charge rule lets immigration officers consider whether an applicant for a green card is likely to become primarily dependent on government assistance. For decades, only cash assistance programs like TANF and SSI counted. In November 2025, the Department of Homeland Security proposed rescinding the 2022 rule and giving officers broad discretion to consider a much wider range of programs — including Medicaid and CHIP.^[5]

This is important: Ryan White HIV/AIDS Program services, including ADAP, are not considered under the public charge rule. Using Ryan White does not count against you in an immigration application. Neither does using community health center services or emergency Medicaid. But the confusion and fear surrounding public charge are already driving people out of care. The KFF/New York Times 2025 Survey of Immigrants found that 42 percent of likely undocumented immigrants stopped participating in a government program that helps pay for food, housing, or healthcare since January 2025 because they did not want to draw attention to their or a family member's immigration status.^[6]

State Laws That Increase Fear

Some states have enacted laws that deepen the climate of fear. In 2023, Florida passed SB 1718, which requires hospitals accepting Medicaid to ask patients about their immigration status on admission and registration forms and submit aggregate quarterly reports to the state.^[7] Patients may decline to answer, and the law states that a patient's response cannot affect the care they receive or be reported to immigration authorities. But the chilling effect has been real — discouraging some undocumented Floridians from seeking any medical care at all, including HIV testing and treatment. Similar measures have been considered in other states.

Sensitive Locations: What Changed in 2025

For more than a decade, Immigration and Customs Enforcement (ICE) and Customs and Border Protection operated under a policy that discouraged enforcement actions at "sensitive locations" including hospitals, doctors' offices, and clinics. On January 21, 2025, the Department of Homeland Security rescinded that policy.^[12] The change generated real fear — and some real confusion about what it actually means.

What the change did: Immigration agents are no longer bound by an internal policy that treated healthcare facilities as generally off-limits for enforcement. That policy is gone.

What the change did not do: It did not eliminate your constitutional rights inside a healthcare setting. Under the Fourth Amendment, ICE and Homeland Security agents generally cannot enter non-public areas of a clinic, hospital, or health facility — including treatment rooms, exam rooms, and staff-only areas — without a judicial warrant signed by a judge. An administrative warrant issued by ICE itself (Form I-200 or I-205) does not give agents legal authority to enter a non-public space. Healthcare staff are not obligated to share information about patients or answer questions from immigration agents without a valid judicial warrant, and HIPAA privacy protections remain fully in force.

HIV, Green Cards, and Immigration Applications

HIV status alone does not make anyone inadmissible to the United States. The 2010 rule change removed HIV from the list of communicable diseases of public-health significance, and that has held since — HIV is not a bar to a visa, green card, adjustment of status, or naturalization.^[3]

Applications for a green card or certain visas still involve an immigration medical exam performed by a USCIS-designated civil surgeon, who completes Form I-693. Testing for HIV is no longer required on that exam. If you disclose your HIV status voluntarily, the civil surgeon is required to certify that HIV is no longer a Class A condition — meaning it will not affect the outcome of your application.

HIV can also be relevant to asylum claims. Applicants who fear persecution in their home country because of their HIV status — including violence, denial of medical care, or targeted mistreatment — may have grounds for an asylum claim on the basis of membership in a "particular social group." Every asylum case turns on its own facts, and if you think this may apply to you, seek help from an immigration attorney or a legal aid organization that focuses on HIV or LGBTQ+ asylum work.

What You Should Know

Healthcare providers in the United States are not immigration enforcement agents. Under federal law, your medical information is protected. You do not have to answer questions about your immigration status to receive care at a community health center, a Ryan White clinic, or an emergency department — and even under Florida's SB 1718, you have the right to decline to answer. Your care cannot be denied because of your immigration status.

Communities Most Affected

HIV affects immigrant communities in the United States in different ways, shaped by country of origin, language, culture, gender dynamics, stigma, and access to resources. Understanding these differences is essential to providing effective care.

Haitian and Caribbean Communities

Haitian immigrants face a distinct set of barriers: extreme poverty, low formal education rates, language access (Haitian Creole is not widely supported in most clinical settings), deep cultural stigma around HIV, and historical mistrust of healthcare systems. Research in Miami has found that among Haitian immigrants living with HIV, approximately three-fourths had not graduated from high school and reported annual incomes of $5,000 or less. Caribbean-born Black immigrants in Florida have been shown to be less likely to be retained in HIV care or achieve viral suppression than most other racial or ethnic groups. Organizations like the Center for Haitian Studies in Miami's Little Haiti conduct outreach in laundromats, churches, and homes because standard outreach channels do not reach this community.

Latino and Hispanic Communities

Between 2010 and 2022, HIV diagnoses in the U.S. dropped by 12 percent overall — but rose by 24 percent among Hispanic/Latino people, per KFF analysis of CDC data.^[8] Latino immigrants from Mexico and Central America are more likely to receive a late-stage AIDS diagnosis, meaning they had little or no prior interaction with the healthcare system until they were already seriously ill. The cultural concept of machismo can discourage men from testing. Power dynamics within relationships can make it harder for women to negotiate protection. Religious frameworks may equate HIV with moral failure. And beyond Spanish, communities from indigenous backgrounds may speak Mam, K'iche', or other languages with virtually no clinical interpretation available. Read more in our Florida deep dive.

African Immigrant Communities

Immigrants from sub-Saharan Africa — including Ethiopia, Nigeria, Kenya, the Democratic Republic of Congo, and others — face HIV-related stigma that can be even more isolating in the United States than in their home countries. Small diaspora communities offer little anonymity, and cultural norms around HIV disclosure can be rigid. Many African immigrants are eligible for refugee or asylee health benefits but do not know these programs exist or how to access them.

Migrant Farmworkers

Migrant farmworkers in agricultural regions across the country — Florida, California, Texas, the Carolinas, and elsewhere — face among the most extreme barriers to any healthcare. Many are undocumented. Many live in employer-provided housing with no transportation. Many work long hours with no sick leave. Many speak indigenous languages. HIV testing, PrEP, and ongoing care are effectively inaccessible without mobile or outreach-based programs.

LGBTQ+ Immigrants

LGBTQ+ immigrants face a double stigma: discrimination related to both their sexuality or gender identity and their immigration status. Many come from countries where homosexuality is criminalized, and the fear of being outed in their communities — whether at home or in the U.S. — can prevent them from accessing HIV services. LGBTQ+ immigrants may be eligible for asylum based on persecution related to sexual orientation or gender identity, but navigating the asylum system while also managing HIV care requires significant support.

Mixed-Status Families and HIV Care

Many immigrant families in the United States are mixed-status: a parent may be undocumented while their children are U.S. citizens, a spouse may be a green-card holder while their partner is in a pending asylum case, an adult may be here on a work visa while their parents are undocumented. When HIV enters that picture, the practical questions get complicated fast — and the good news is, in almost every case, care is available for everyone in the household, just through different doors.

Common Family Configurations

Undocumented adult, U.S.-citizen children: The adult can access HIV care through Ryan White and community health centers regardless of status. The children are eligible for Medicaid or CHIP in their state and can receive full pediatric care. In most states, a parent can enroll their eligible child in Medicaid without the parent's own immigration status being reported.

Mixed-status couple, one partner living with HIV: The partner living with HIV accesses Ryan White for treatment. The HIV-negative partner can access PrEP either through a health-center sliding-scale program, telehealth PrEP with the Ready, Set, PrEP national program, or the federal Ready, Set, PrEP program, which does not check immigration status.

Undocumented person newly diagnosed, no U.S. citizen family: Ryan White is the first stop. Case managers there can help identify a community health center, ADAP enrollment, and any state-specific safety-net programs you may qualify for.

Language Access: Your Right to an Interpreter

Under Title VI of the Civil Rights Act of 1964, any healthcare provider that receives federal funding — which includes essentially every hospital, community health center, and Ryan White clinic in the country — must provide meaningful language access to patients with limited English proficiency. That means free, professional interpretation, not billing you for the service and not asking a family member or child to translate medical information.^[13]

Languages with widely available support include Spanish, Haitian Creole, Portuguese, Mandarin, Cantonese, Vietnamese, Korean, Arabic, Russian, and French. Indigenous languages such as Mam, K'iche', and Zapotec are less widely supported but a growing number of health systems are building capacity for them. If your primary language is not one commonly supported, ask specifically for phone-based interpretation through a national language line — most clinics contract with services that cover hundreds of languages.

Telehealth: A New Path to Care

For immigrants facing barriers to in-person care — fear of being seen at a clinic, lack of transportation, work schedules that do not allow time off, rural isolation — telehealth has become a powerful alternative. Since the COVID-19 pandemic, telehealth for HIV care has expanded dramatically. Before the pandemic, only a small fraction of HIV providers offered telehealth; during COVID that number jumped sharply, and most have continued offering virtual options.

PrEP by Telehealth

Nearly 20 percent of PrEP users in the United States — more than 110,000 out of roughly 580,000 people using PrEP in 2024 — now receive their PrEP through telehealth, according to a 2025 Emory/JAMA Network Open study.^[10] That is up from less than 1 percent in 2019. National telehealth providers like MISTR partner with community-based organizations that use the federal 340B drug pricing program to offer free PrEP consultations, at-home HIV and STI testing kits, and medication delivered to your door in unmarked packaging. No clinic visit required. No insurance required. In the Emory study, more than one-third of telePrEP users were uninsured.

HIV Treatment by Telehealth

Many Ryan White-funded clinics now offer hybrid care models where some visits can be conducted by video or phone. Research has shown that people who use telehealth for HIV care maintain viral suppression at rates equal to or better than those seen in person only. HRSA and HHS published a Telehealth for HIV Care Best Practice Guide in December 2024 to help providers integrate virtual care into their programs, with specific guidance for people living with HIV and their providers.^[11]

Why Telehealth Matters for Immigrants

Telehealth removes several of the most significant barriers immigrants face: you do not have to be seen entering a clinic. You do not have to take time off work. You do not need transportation. You can receive care from the privacy of your home. Medications and testing kits arrive in discreet packaging with no visible indication of what is inside. For people living in fear of immigration enforcement, telehealth can be the difference between staying in care and dropping out entirely.

Finding Care

No matter where you are in the United States, care is available to you. Here are the most important resources:

Ryan White clinics provide HIV medical care, medications, case management, and support services regardless of immigration status. Use our Care Locator to find providers near you.

Community health centers (FQHCs) serve patients regardless of status or ability to pay. Find one at findahealthcenter.hrsa.gov.

ADAP provides free or low-cost HIV medications in every state. Undocumented individuals are eligible. Ask your provider or case manager about enrollment.

Telehealth providers offer virtual HIV care and PrEP services nationwide. No in-person visit required for many services.

Local health departments provide HIV testing, often free and confidential, in most counties across the country.

If you need help and do not know where to start, you can reach us at kevin@riseuptohiv.com. We will help you find care. You are not alone.