Overview
Research published on February 10, 2026 in The Lancet Regional Health – Europe links Immigration, poverty, and HIV risk in the Netherlands through social and economic barriers, not through migration itself. The study focuses on how legal status, money stress, and day-to-day access problems shape who gets tested, who gets diagnosed late, and who gets care on time. For immigrants, the stakes are immediate. A delayed diagnosis can follow from missed appointments, fear about eligibility, or simple cost barriers like transit fares to clinics. Those pressures often sit on top of unstable housing, irregular work, and long waits for documents. The core message is structural: when people live with fewer resources and less certainty, health systems become harder to reach, and risk rises.
Findings
The February 2026 analysis was led by Dr. Vita Jongen from Stichting HIV Monitoring and describes a “social gradient” in HIV diagnoses. Put plainly, people with fewer resources and weaker access pathways show up more often in new diagnoses than their share of the general population would suggest.
The headline numbers are stark. Immigrants accounted for 40% of people newly diagnosed with HIV in the Netherlands, while immigrants make up 23% of the general population. That gap points to uneven access, uneven testing patterns, and uneven “early entry” into care, rather than a simple story about where someone was born.
Among men diagnosed with HIV, 23% lived below the poverty line, nearly double the 12% baseline in the general population. Poverty here works like friction. It turns a clinic visit into a day off work, a transport bill, and a hard choice about childcare or rent.
The study also reported a strong intersection for women. 55% of women diagnosed with HIV were first-generation immigrants, and many also fell below the poverty line. That pattern fits a broader reality in public health: risk grows when people face layered barriers, like language gaps, limited social networks, and uncertainty about rights.
The mechanisms described were practical and familiar to anyone who has handled cross-border health access. The study pointed to language barriers, uncertainty about healthcare rights, and the cost of travel to clinics. Those obstacles delay testing, delay treatment, and increase the chance of late diagnosis, which worsens outcomes and raises stress in daily life.
USCIS–DHS procedures in 2026
In the United States, it’s essential to separate medical rules from case-processing actions, because they affect people in different ways. First, HIV is not a ground of inadmissibility under current federal health-related rules. USCIS states: “As of January 4, 2010, human immunodeficiency virus (HIV) infection is no longer defined as a communicable disease of public health significance… Therefore, HIV infection does not make the applicant inadmissible on health-related grounds.” That language appears in the USCIS Policy Manual, Volume 8, Part B, Chapter 6, available here: USCIS Policy Manual (Volume 8, Part B, Chapter 6).
Second, separate from health inadmissibility, USCIS described a 2026 approach that can still disrupt people’s lives through timing. In USCIS Policy Memorandum PM-602-0194, dated January 1, 2026, the agency stated it would place “an adjudicative hold” on pending benefit requests for nationals from “high-risk countries identified in PP 10998,” while completing “a thorough case-by-case review.” The policy affects nationals from 39 countries, including Nigeria, Senegal, Angola, and Malawi.
For applicants, an adjudicative hold is experienced as process, not diagnosis. It can show up as extra review time, additional checks, and a longer period of living in limbo while a case remains pending. It also often changes the rhythm of family planning, job decisions, school enrollment, and health coverage choices.
A realistic step-by-step of what an “adjudicative hold” period feels like
- Filing and initial receipt: You submit the petition or application and receive a receipt notice, then wait while the case enters the queue.
- Review and possible request: An officer reviews the file and may issue a request for evidence or other follow-up, which requires organized and fast replies.
- Extended checks: Background or security review can continue while the case stays pending, which can delay work decisions and travel planning.
- Decision or next procedural step: Once review is complete, USCIS issues an approval, denial, or another formal action tied to the benefit type.
This is where readers often confuse concepts. A hold is an administrative pause or added scrutiny. It is not the same thing as a legal rule that excludes people for having HIV.
Poverty rules: where thresholds matter in US filings
Poverty guidelines matter in immigration in specific, document-heavy ways. They most often appear in decisions about fee waivers and in financial paperwork used to show a household can meet obligations tied to a filing. USCIS updated its poverty thresholds on January 13, 2026, and those numbers feed into eligibility checks and financial evidence expectations.
One common touchpoint is the fee waiver process through Form I-912. People use it to ask USCIS to waive certain filing fees when they cannot pay. The key is paperwork that fits the rule, because “low income” needs to be demonstrated in the format USCIS accepts. The official form page is here: Form I-912, Request for Fee Waiver.
It’s also important to keep “public charge” separate from fee-waiver thresholds. The current framing focuses on the likelihood of becoming primarily dependent on the government for subsistence, rather than treating health status itself as disqualifying. That distinction matters for immigrants living with poverty, because the same financial facts can appear in different contexts with different legal tests.
Evidence that supports a low-income claim tends to be concrete and organized. Applicants usually rely on items like proof of income, proof of benefits, household size documentation, and records that show hardship factors that affect the ability to pay fees on time.
Why these findings matter during real immigration journeys
The Dutch findings help explain why poverty and administrative friction worsen health outcomes without blaming immigrants for the risk. When someone is choosing between rent and transport to a clinic, healthcare becomes a scheduling problem and a money problem first. Late diagnosis is not only a medical issue. It’s also a symptom of fragile stability.
Language barriers intensify that fragility. If you cannot confidently read eligibility rules, clinic intake forms, or appointment instructions, you delay care. If you fear that seeking services could affect your status, you delay care again. Those are predictable effects of uncertainty, not personal failure.
Immigration processes add their own stressors, especially during long waits. A case held for additional review can interrupt job offers, delay travel to see family, and complicate health insurance enrollment. Even when a benefit remains legally available, time itself becomes a cost. That cost lands harder on people already living close to the edge.
This is also where HIV risk intersects with daily logistics. Stable care works best when appointments are predictable, transport is affordable, and people can take time off work without losing pay. Poverty undermines each of those supports. Add an immigration case delay, and the same person may lose stability in housing or work, which then spills into missed medical follow-ups.
VisaVerge.com reports that these layered pressures often show up first as small delays—one missed appointment, one unanswered letter, one month without steady pay—before they grow into bigger health and legal problems.
Verifying rules before you file or respond
For readers dealing with cross-border questions about health and immigration, the best protection is checking the current official text before you act. The USCIS Policy Manual is used to confirm how officers are instructed to apply the law, including how HIV is treated in health-related inadmissibility analysis. When a rule is quoted, verify the volume, part, and chapter so you know you are reading the same framework an officer uses.
For poverty-related steps, focus on documents that USCIS uses across filings, and confirm the version date when you collect your evidence. Poverty guideline updates can change what counts as eligible for a fee waiver, and they can change how a household’s numbers fit a form’s instructions.
When you prepare a response, treat the process like a checklist. Match each claim to a document, label exhibits clearly, and keep copies of everything submitted. That discipline reduces avoidable delays and helps keep health care, work, and family plans steadier while immigration steps move forward.
