Healthcare Access and Linkage to HIV Care in the Netherlands: Qualitative Insights from Sub-Saharan African Migrants and Key Informants

Sub-Saharan African migrants (SSAM) face notable health disparities, yet research on their experiences accessing healthcare services, including for HIV, is limited within the European context. Using a socioecological framework, we explored barriers and facilitators to general healthcare access and linkage to HIV care (LtHC) from the perspectives of a diverse group of 32 SSAM and 13 key informants (KI) in the Netherlands through semi-structured interviews and inductive thematic analysis. Barriers to general healthcare included negative perceptions of the Dutch healthcare system and financial constraints. Disclosure challenges hindered LtHC, while linkage support acted as a key facilitator. Migration-related challenges, bureaucratic healthcare processes, and community-based support for care connections were identified as intersecting factors acting as barriers and facilitators to general healthcare access and LtHC. This study underscores migration as a critical determinant embedded within broader systemic and structural factors influencing healthcare access. Addressing health inequities for SSAM necessitates migrant-inclusive and culturally responsive healthcare policies and practices. These interventions are crucial for tackling persistent health(care) disparities and ensuring that no one is left behind, particularly those in precarious situations.