Journal Article

OC59 Facilitators and barriers HIV/STI information and services among LGBTQI+ immigrants in Italy

Barracchia, M, Falaguasta, M, Mazzitelli, M, Ranjit, Y S, Costacurta, M

2025

Overview

IntroductionItaly receives thousands of immigrants every year, some of whom seek asylum to escape the hostility and violence related to homophobia in their home countries. Lesbian, gay, bisexual, transgender, intersex, queer/questioning (LGBTQI+) immigrants in Italy are disproportionately affected by HIV. In Italy, ‘people born abroad’ are a high-risk population who are least likely to be aware of their HIV status. This demonstrates an acute lack of access to timely HIV testing. This study, thus, aimed to understand the facilitators and barriers to health services among this population in Italy.MethodWe conducted 33 semi-structured interviews and two focus group discussions (n=14) in Italian, English and Spanish languages. We recruited participants through community-based organizations in North, Central and Southern Italy. Eligibility included: migrated to Italy ≤10 years ago, identified as LGBTQI+, ≥18 years old. Participants were from South America, Asia and Africa. Audio files were transcribed and translated into English. Phronetic iterative process was used to analyze data. Ethical review was approved by the University of Missouri (IRB# 2104686).ResultsThe mean age was 30.5 years (SD=8.5). Average years in Italy was 4.8 years (SD=6.61). Sixteen (50%) were cismen, 4 (23.5%) were ciswomen, 5 (15.6%) transwomen, 2 (6.3%) transmen and 5 (15.6%) identified as non-binary. These themes emerged: stigma and discrimination due to intersecting minority identities, language difference and lack of support. Regarding LGBTQI+ identity, race and immigrant experience, a participant said, ‘In Italy-I always say homophobia stripped me of respect, racism stole my dignity.’ Another participant recounted their experience of filling out forms at a health center, ‘They bring you to a point of anger and you enter the stereotype of a racialized person, of someone who is always angry. A person who insults you, who throws documents in your face, for them you must stay calm,’ highlighting institutional discrimination. Participants also spoke about the rising cost, ‘I used to pay 150€ for Tessera Sanitaria. But they increased it to 700–800€. It’s incredible, wild.’ Among facilitators, participants mentioned having the support of community health organizations gave them confidence to seek and understand HIV/STI prevention information and connect with services. One participant said, ‘This place helps you remove that shame, bring out that boldness in you to meet up with someone and get some information.’ (Table 1)Abstract OC59 Table 1Themes of Barriers and Facilitators of Accessing Healthcare Services for LBGTQI+ Immigrant in ItalyConclusionLGBTQI+ immigrants in Italy experience individual and structural barriers to access HIV/STI prevention and treatment services, including stigma, discrimination and lack of communication services. This group seem to navigate the health system with the help of community health organizations. Communication technologies could potentially bridge the gap of information to reach a wider population of immigrants in need physical and psychological healthcare.

• Publisher: BMJ Publishing Group LTD
• Subject: HIV / Homophobia / Human immunodeficiency virus / Immigrants / Non-binary gender