While funds are being cut worldwide and right-wing governments are attacking minorities, queer migrants are reorganising themselves – beyond large institutions, out of sheer necessity and collective strength. On World AIDS Day 2025, Wíner Ramírez Díaz from the Paris collective Maricolandia, how grassroots communities fight HIV/AIDS, discrimination and neoliberal exclusion on a daily basis – and why their resistance is crucial for any future without HIV/AIDS.
This article highlights key aspects of the fight against HIV/AIDS, drawing on practical experience with the population groups that are most affected both epidemiologically and psychosocially: the so-called key populations. Especially on World AIDS Day on 1 December, it is important to me to highlight activist perspectives. My aim is not so much to present solutions to functional or structural problems, but rather to show the concrete realities on the ground and to sound the alarm in view of the deep-seated dysfunctions that characterise this fight throughout the entire care cascade.[1]
What is the context of this struggle?
According to the UNAIDS Fact Sheet 2025, around 40.8 million people worldwide were living with HIV in 2024, and approximately 1.3 million people were newly infected. Around 630,000 people died of AIDS-related illnesses in 2024, and around 31.6 million people gained access to antiretroviral therapy.
These figures clearly show how great the challenge remains to achieve a world without HIV/AIDS. In Europe, for example, according to the WHO Regional Director for Europe, Dr Hans Henri P. Kluge, half of the people living with HIV in Eastern Europe and Central Asia still do not have access to antiretroviral treatment. Since 2010, this figure has risen by 49 % – in a region that is among those with the highest rates of new HIV infections worldwide.[2]
The contradictions in the struggle
In the 1980s, the emergence of AIDS fundamentally changed the dynamics of sexual minority movements. Gay and bisexual men were the hardest hit within the LGBTQIA+ community. This tragic turning point was also a moment of coming together: people with non-normative sexuality organised themselves to counter the crisis. This led to the creation of organisations such as ACT UP (internationally known), AIDES in France, Deutsche Aidshilfe (DAH) and others – as well as intra-community movements such as the Sisters of Perpetual Indulgence, whose commitment continues to this day.
2008 marked a real revolution in HIV prevention: the „Swiss Declaration“ by Professor Hirschel and colleagues, which stated that people with HIV who are successfully treated and Viral loadViral load refers to the amount of viruses that can be detected in a person's blood. - In the case of HIV, the viral load indicates how many HI viruses per millilitre... Mehr below the detection limit, HIV is no longer transmitted during sex; as well as the emergence of PrEP. Both developments ushered in a fundamental paradigm shift in the toolbox of HIV/AIDS prevention. According to sociologist Cyriac Bouchet-Mayer, however, the 2010s also mark a turning point: traditional condom promotion took a back seat, while testing and access to preventive multi-therapies for „key populations“ gained in importance. But apart from a privileged group of men who have sex with men (MSMMSM is the abbreviation for "Men who have Sex with Men" - i.e. men who have sex with men. - The term describes behaviour, not ... Mehr), other key groups – such as intravenous drug users, sex workers or migrants – are hardly present in the testing centres.
However, this exclusion is not limited to hospitals: it extends to most institutional facilities that are actually supposed to reach precisely these population groups. Although campaigns to combat HIV/AIDS have become more representative in recent years – for example, for racialised people, transTrans (short for transgender or transident) describes people whose gender identity does not match the gender they are assigned. Mehr People, fat people or migrants. However, the life experiences of extremely small minorities remain marginalised. They stand at a crossroads of diverse structural oppressions that shape and complicate their lives. The very groups that are considered „key groups“ in public health – and should therefore be at the centre of prevention and risk reduction measures – are also the ones most affected by exclusion.
The difficulties faced by extremely small minority groups
In the report on World AIDS Day 2025 entitled „Overcoming disruptions, transforming the response to AIDS“ (roughly translated as: „Overcoming obstacles, changing the response to AIDS“), UNAIDS notes a drastic decline in international aid. This is due to the policies of governments in the northern hemisphere, which are increasingly withdrawing from the global fight against HIV/AIDS.
For large NGOs, this decline poses an existential threat. Shrinking financial resources jeopardise prevention efforts. They also jeopardise access to treatment. This makes the goal of defeating HIV by 2030 increasingly difficult to achieve.
At the same time, despite funding cuts, something new is emerging. Despite the waves of hatred against LGBTQIA+ people fuelled by far-right governments, transTrans (short for transgender or transident) describes people whose gender identity does not match the gender they are assigned. Mehr People and migrants are developing rebellious community projects. These projects are emerging outside of traditional association structures. They are reacting with resistance to the shift to the right in the global North. In Europe, anti-migration measures are further hindering the social participation of these groups.
Various LGBTQIA+ migrant movements work closely with networks, associations and hospitals – individually and collectively. They protect their own health and promote prevention tools such as PrEP, TasP and PEP. The study „Parcours en France“ (2015) from public health research shows that many migrants only become infected with HIV after arriving in France. LGBTQIA+ migrants and migrant sex workers face numerous hurdles. Administrative, linguistic and material barriers affect their health. At the same time, they increase the risk of experiencing violence.
Dangerous laws: How France is abandoning queer migrants with HIV
In France, people with HIV/AIDS can generally apply for a residence permit on medical grounds. The reason for this is that in many countries of origin, access to medication is lacking. However, the authorities are increasingly rejecting these applications. Instead, those affected receive OQTF notices (Obligation de Quitter le Territoire Français), meaning they must leave French territory. This puts their lives in acute danger.
This reality became particularly apparent during the COVID pandemic. Migrants faced enormous difficulties in accessing preventive measures such as therapy or PrEP – regardless of whether they were living with HIV or working in the sex industry. Many were barely able to go about their daily lives without running a high risk of being stopped by the police.
Added to this is the French law of 2016, which provides for the punishment of clients in sex work. It poses an acute danger to sex workers, whether they have a migration background or not. The so-called Nordic model has been shown to lead to more risky sexual encounters without condoms. It is accompanied by an increase in sexualised and sexist violence. Criminalisation is driving many sex workers underground. Since 2018, at least three South American transTrans (short for transgender or transident) describes people whose gender identity does not match the gender they are assigned. Mehr Women in sex work lose their lives. For years, numerous organisations have been denouncing this legal situation – because it makes life more difficult for transTrans (short for transgender or transident) describes people whose gender identity does not match the gender they are assigned. Mehr and LGBTQIA+ migrants massively.
Back to basics – struggle and collective resistance: a collective experience
In 2018, a group of queer migrants from Latin America came together. This led to the formation of a community in a major European city. Together, they fight against HIV/AIDS and the discrimination that shapes the lives of queer, migrant and sex workers.
We have created a collective called Maricolandia. It offers queer and transTrans (short for transgender or transident) describes people whose gender identity does not match the gender they are assigned. Mehr A space for people from the Global South who have migrated to the Global North. The space is open to all migrants who identify as «maricas» – that is, as queerQueer is a collective term for people whose sexual orientation or gender identity does not conform to the social norm of "heterosexuality". Mehr, gayGay refers to men who are romantically and/or sexually attracted to men. Important facts about the term: - "Gay" is the term used to... Mehr, transTrans (short for transgender or transident) describes people whose gender identity does not match the gender they are assigned. Mehr etc. – identify as queer and live in France or other parts of Europe. Our collective is based on mutual support, sharing, love and queer joie de vivre. As a collective, we take a stand against transphobia, homophobia, racism, xenophobia, serophobia (discrimination based on HIV status), homonationalism, gaypitalism, precariousness and neoliberalism. At the same time, we denounce the socio-institutional logics appropriated by the state and the market.
Siblings who have also migrated from the south are also welcome in our space. Many of us have been and continue to be affected by various forms of oppression. These include migration status, sexuality, HIV status and other factors. Despite limited resources and little room for autonomous organisation, we have built up a network of solidarity. It primarily supports undocumented migrants, asylum seekers and migrant sex workers. We are also confronted with the reality of chemsex. That is why we work closely with public health services. This gives marginalised people access to risk reduction services and ensures that they are well supported within our community.
Self-organisation in action: prevention, political work and joie de vivre
Our work focuses on the precarious living conditions of migrants, health and prevention, and all the administrative and everyday steps involved. This horizontal support takes place in our workshops, in French courses for everyday life, and in our various social counselling services. At the same time, we participate in political events – and organise some ourselves.
In the evenings, we create moments where we can dance, be loud and wild – and at the same time strengthen each other for the activities that lie ahead.
Every weekend, we hold a French course, organised by us for us. This course helps us to break through the isolation of our siblings and learn the language. At the same time, we convey important messages about risk reduction and prevention in the area of sexual and community health in the workshops. We share our collective knowledge to address diverse forms of oppression, administrative hurdles, difficulties in finding housing, studying or asylum procedures, problems with sexual health or dealing with chemsex.
We organise days and celebrations to raise funds for our work. And we never forget that this fight will from us and for led us – because we have no other choice.
Working together to combat HIV/AIDS
Our shared space allows us to reflect on what the fight against HIV/AIDS must look like in the coming years – and how we are already fighting it in our everyday lives. This fight is comprehensive: it cannot be reduced to epidemiological or health policy issues. The struggle of LGBTQIA+ migrants is inextricably linked to the struggles of all sexual minorities and must be anti-racist, anti-xenophobic, feminist, disability-friendly and, of course, HIV-inclusive.
Our collective experience strengthens our resistance. This is how we fight back against the ultra-neoliberal functional logic that characterises many large organisations in the fight against HIV/AIDS. These structures increasingly function as service providers for a capitalist, neoliberal system. They enforce competition and use the work of sexual minorities as a resource to maintain this logic. We take a clear anti-homonationalist. Our identities are non-negotiable. They must never be used to legitimise hatred or violence against our brothers and sisters.
365 days of World AIDS Day, 365 days of resistance: against gay capitalism, hatred and indifference
We live in a time when many rights that were long taken for granted are once again being called into question. Ultra-conservative forces are openly attacking them. Our collective projects must therefore be a counter-model: they should inspire, counter indifference and oppose the commercialisation of our identities („gaypitalism“). At the same time, they oppose a tendency within our own communities to suppress political struggles in favour of individualised pleasure-seeking. This logic ignores people who are like us and suffer from diverse forms of oppression.
Finally, I invite everyone to realise that our fight does not only take place on World AIDS Day on 1 December. We are active 365 days a year. We are fighting to prevent HIV/AIDS transmission in ultra-minority groups such as LGBTQIA+ migrants.domestic and migrant sex workersAnd we are fighting for more dignified living conditions overall.
The experiences of HIV-positive people must be heard beyond the usual prevention slogans, which reduce their reality to „undetectable = untransmittable“. We must not forget that HIV/AIDS primarily affects those who are most at risk and exposed to multiple levels of oppression.
Let's mobilise, take action – and join the fight together on World AIDS Day!
[1] The UNAIDS HIV cascade targets 95-95-95 are a global goal to eradicate the HIV/AIDS epidemic through improved access to medical care. They are divided into three main targets, each of which is to be achieved by 2030: 95% of people living with HIV are aware of their status. Of these, 95% receive life-saving medication. And of these, 95% respond so well to the medication that HIV is not sexually transmissible.
[2] https://www.who.int/europe/fr/news/item/22-07-2024-statement—ending-aids-by-2030–we-can-keep-the-promise
