Barriers and Delays: Factors Influencing Healthcare Access and Late HIV Diagnosis Among Queer Migrants in the Netherlands

Queer migrants in the Netherlands face significant barriers to timely HIV diagnosis and care, contributing to ongoing public health challenges that intersect with social equity, migration, and sexual identity. Despite advancements in HIV prevention and care, disparities persist. As of the end of 2022, 62% of the total 24,400 PLHIV belongs to Men who have sex with men (MSM) group. Nearly half of new HIV diagnoses from 2020 to 2022 were at a late stage, with higher rates among migrants from sub-Saharan Africa (65%) and South Asia (61%). This review aims to identify factors contributing to late HIV diagnosis among queer migrants in the Netherlands and explore their impact on healthcare access and outcomes to achieve the 95-95-95 target. Levesque et al.'s conceptual framework was used to analyse healthcare access, focusing on approachability, acceptability, availability, affordability, and appropriateness.

A systematic literature review was conducted, analyzing peer-reviewed articles from 2010 to 2024 in English using databases like PubMed, Scopus, Web of Science, and Google Scholar. The search included terms related to HIV Late representation, queer migrants, and healthcare access in the Netherlands.

The review highlights significant barriers to early HIV diagnosis among queer migrants in the Netherlands, including limited healthcare access, stigma, discrimination, and cultural differences. Structural barriers like legal restrictions and sociocultural factors such as low perceived risk and lack of awareness further hinder timely diagnosis and effective treatment. Queer migrants also face language barriers, financial issues, and dissatisfaction with the healthcare system, contributing to high rates of late-stage HIV diagnoses and poorer health outcomes.

These findings highlight the need for targeted interventions to improve healthcare access for queer migrants in the Netherlands. Addressing legal and cultural barriers, enhancing healthcare provider competence, and expanding outreach programs are essential to reducing disparities in HIV care and achieving equitable health outcomes.