Life in Northern Gaza is precarious enough without having to worry about AIDS. Airstrikes and ground raids are a constant threat that keep people from leaving their homes to find food. “We have to conserve,” said E.S., a 27-year-old who lives with his mother and younger brother in the Tel al-Hawa neighborhood in southwest Gaza City. “People are fighting each other to get the aid boxes.”

And then there’s the issue of medication.

“My doctor told me that the antiretrovirals have been consumed completely and there is nothing left in store,” said E.S., who is HIV-positive and agreed to speak with The Intercept using a pseudonym to avoid community stigma and targeting by the Israeli authorities.

He needs tenofovir, a common HIV medication, and lopinavir/ritonavir, a much more rarely prescribed one. At times, E.S. has had so little left that he dangerously began rationing his pills by skipping morning doses. “There are no more supplies coming in or there hasn’t been any supplies at all coming in to the south or to the north,” he typed in a direct message. While Israel has denied blocking medication, international aid groups like Glia have told The Intercept that HIV medication specifically has been blocked from entering the Gaza strip.

Without these medications, E.S. — who already uses a walker for mobility — would see his health deteriorate rapidly. Within a short span of time, he would begin to move even more slowly, and he might lose the ability to walk altogether. With soldiers mandating mass displacement and sniping Palestinians as they try to evacuate, this could mean a death sentence.

As Israel’s war on Gaza rages around him, E.S. has spent most of his time at home with his two cats. While many of his neighbors moved south to Rafah, he stayed put with his brother and mother, who is a cancer survivor. His limited mobility, the result of a viral infection exacerbated by HIV, made leaving more dangerous than staying.

So they chose to stay north — despite warnings from the occupation military to evacuate. His home, while offering more protection than a tent, hasn’t exactly been safe: “I saw people get sniped right across the street from me. It was a family of five trying to cross the road after they were ordered to evacuate their building before it was bombed.” He said the parents died and the children survived.

E.S. used to get his medication from Al Rimal Martyrs Clinic, but it was evacuated and then reinhabited by displaced Palestinians.

“Now, with the genocide happening, I fear not only my health deteriorating, but also how my family will respond,” he wrote. For years, his family didn’t acknowledge his HIV status; now he worries that his condition will be a liability for them.

There is an added terror for Palestinians in Gaza who must hunt down vital medications. It’s especially hard for those few dozen looking for stigmatized HIV meds.

According to “HIV/AIDS in Palestine: A growing concern,” a 2020 article in the International Journal of Infectious Disease, there have only ever been about 100 cases of HIV officially documented by the Palestinian Ministry of Health. Still, the report found, “the Middle East and North Africa region is considered an area of increasing concern for HIV infection due to high mortality associated with AIDS” in general, and “Palestine (the West Bank and Gaza Strip) is part of this concern.”

This is because HIV incidence is slowly increasing, and untreated HIV-positive Palestinians are progressing toward cases of AIDS. Similar to HIV dynamics among Black queer men in the Mississippi Delta, in Palestine, “within a short time patients become susceptible to opportunistic infections, probably due to the late diagnosis and presentation of the cases.”

And as outbreaks in America and Greece have shown, without adequate testing and screening, even a few cases of HIV can rapidly increase.

As recently documented in Ukraine and Russia, wars have long exacerbated HIV transmission. In Gaza, the universal protocols needed to prevent blood-borne infections simply cannot be followed.

The Gaza Ministry of Health told The Intercept that it contacted HIV patients at the beginning of the war, urged them to visit specific health facilities, “and their treatments were dispensed for a period of 3 months.”

“Now, unfortunately, their treatments are not available,” the ministry added.

Bombings routinely cause Palestinians with no training (let alone latex gloves) to desperately try to save their wounded neighbors, hospitals lack water for washing hands or surfaces, and patients with gaping wounds are treated on blood-soaked floors.

With Gaza’s few hospitals targeted and largely destroyed — and with more than 1,000 of its health care workers killed and others detained — this is not an environment where any virus can be contained.

E.S. was born and raised in Gaza. He grew up Muslim but doesn’t practice the religion anymore. He describes himself in many ways: as someone who is very spiritual, with a deep connection to the divine. As an artist, with a focus on mixed-media work related to gender expression and Gaza. As someone who is HIV-positive. As Palestinian. As queer.

“I like ‘queerness,’ it kind of represents my wanting to be free and, like, fluid,” he wrote.

E.S. grew up exploring sexuality with his classmates and neighbors. Many of them are married to women now, he explained. He also had unfortunate experiences that he didn’t consent to with some men.

E.S. spent a year in the United States as an exchange student in high school. He applied to colleges there afterward but, while waitlisted, began his studies in Turkey in early 2014 as a scholarship student. It was then that he first felt symptoms which he worried might mean he had HIV. In the same year, he got a scholarship to study at an American college, and by the end of 2016, he moved to the Midwest, where he was first diagnosed with HIV and syphilis and treated with antiretroviral medication. Feeling he could no longer deal with his illness alone, he left the United States in 2019 and returned home to Gaza.

Gaza has been the love of his life, the beach most of all. “It’s the only place where I feel at peace with myself.”

But when he returned, E.S. didn’t know a single other queer person, let alone anyone else with HIV. When his parents found out about his HIV status, they told him it was his fault and they were worried it would........

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