By most accounts, the number of people living with HIV is as low as 100 in Gaza—the Israeli–occupied Palestinian territory that has been devastated by bombs and needs-of-living blockades since Israel began bombarding the coastal region after the October 3, 2024, attacks on Israel by Hamas. (Between 1,000 to 2,000 people died in the October 7 attacks; current estimates put the subsequent death toll in Gaza as approaching 50,000, possibly much higher, with more than 100,000 wounded.) 

But Gazans living with HIV make up a tiny percentage of all Gazans who have gone without medications, treatment and care for pre-existing or acute conditions since Israel’s attacks began—in part because the attacks have decimated most of Gaza’s hospitals and medical centers and, say reports, Israel has largely blocked medical supplies getting in from other countries.

Because Gazans living with HIV are few, and because stigma and silence related to HIV and adjacent issues like LGBTQ identity are high in this conservative region, it has been—and remains—hard to get a clear picture of how Gazans with HIV have been faring. Questions such as whether they had enough supply of HIV meds to last through months of bombings and deprivation, as well as access to any routine HIV-related medical care, have mostly gone unanswered.

But now at least a peek at the situation has been provided by queer American journalists Afeef Nessouli (who is of Lebanese descent and speaks Arabic) and Steven Thrasher, whose in-depth portrait of at least one Gazan living with HIV, the queer “E.S.,” age 28, was published by The Intercept on January 13. The story describes E.S.’s twisting, tortured path to treatment and care in the past 15 months since Gaza descended into chaos.

Nessouli (who reports for The Wall Street Journal, CNN, them.us and on his own Instagram) and Thrasher (a journalism professor at Northwestern and author of the book The Viral Underclass) talked to POZ on January 14 about collaborating on the Intercept story about E.S.

To shorthand your story, E.S. reached out to you, Afeef, in early 2024 and thus began a correspondence with him and those related to him that have led, as of now, to his having at least a temporary supply of his needed HIV meds. How did this story come to be and what was your collaborative process behind it?

Nessouli: Early in 2024, I’d started telling the stories of different queer people in war-torn Gaza on my Instagram. These were people I found on the site Queering the Map [which presents stories of queer people globally]. This was while a lot of pinkwashing was going on [that term refers to what some critics of Israel point to as Israel’s touting its LGBTQ friendliness and highlighting homophobia in surrounding Arab countries as a distraction from its actions in its Palestinian occupied territories of Gaza and the West Bank]. So E.S. [whose full name Nessouli and Thrasher withheld to protect his safety] contacted me in March after seeing my Instagram, then a few days later revealed to me that he had HIV and didn’t want anybody to find out, but that he was running out of his HIV meds and didn’t know what he was going to do. 

Thrasher: I’d also seen on Queering the Map after October 7, 2023, these heartbreaking stories of queer people in Gaza. And since Israel’s retaliation on Gaza after October 7, I’d been wondering, as a longtime reporter on HIV and AIDS, what was happening with people with HIV and AIDS in Gaza. 

Nessouli: Meanwhile, E.S. told me that he was walking with a walker because he had neurological damage from syphilis that had gone untreated. As for HIV, he believed that he got it about 10 years ago in Turkey. Then he came to the United States on a scholarship, where his HIV was diagnosed, and he got on HIV meds and treatment. But he was so homesick that he went back to Gaza, where he stopped receiving care. Once Israel started bombing Gaza after October 7, the medical depots were getting hit. But by this point, despite not approving of E.S.’s effeminacy, E.S.’s father spoke to a friend who helped connect E.S. to the Gazan health ministry. 

In terms of reporting this story, I recorded hours of taped conversations with E.S. and Steven filled in the medical research.

Thrasher: Once Afeef and I started working on the story together, it took me all of an afternoon to read every scientific paper on HIV in Gaza, because there aren’t many. But one hallmark is a propensity for late-stage diagnosis [not until AIDS has developed] of HIV, something like what we’ve seen with some Black people in the U.S. Deep South. Then Afeef and I would each write sections of the story and edit each other.

Did The Intercept ask for documentation—tapes of conversations, screenshots of DMs, etc.—to verify the reality of both E.S. and his story?

Nessouli: I didn’t show them a lot—maybe some screenshots and pictures. They more or less trusted me. My first aim was to help E.S. get more medication, which he did in early December. It felt like a race against time. E.S. would have depressive states but he’s also a very spiritual and positive person. Also, we connected The Intercept to one of his doctors, and The Intercept also made us talk to the Israeli government.

What did you learn about the picture of HIV in Gaza before October 7? How many people were living with it and could they easily get meds and care?

Thrasher: I’d read that there were only about 100 known cases in Gaza, which seemed like an undercount, but this was based in part on a count that the Gaza health ministry did in the 2010s. Not that many Gazans have HIV. It’s a small society but it covered health care, even if it offered no education about any kind of sex outside marriage.

I would say that getting meds and care for HIV pre-October 7 was kind of normal, except for the societal stigma that would make folks with HIV feel pressured not to. There’s also no open kind of network or support group there for people with HIV. Most people living with it would not know anyone else living with it. But right after October 7, the government apparently did contact everyone they knew living with HIV and gave them a three-month supply of meds, as opposed to the usual monthly supply.

Do either of you know anything about what life is actually like for queer people in Gaza? Is there any kind of open organizing or affiliations like there have been in Lebanon the past several decades?

Nessouli: I’ve spent time in the West Bank, not Gaza, but I’ve talked to several queer people in Gaza. It’s very right-wing and queer life is not public, but queer people there have told me that they find each other, hang out and have sex and relationships. Lots of queer Gazans post on Queering the Map. But also, queer people there have told me that their first identity is Palestinian, and their priority is the basics of life.

I understand that E.S. went back to Gaza from the United States because he was homesick. But did he understand that he was leaving behind fairly stable access to HIV meds and care, as well as a more open setting for people with HIV?

Nessouli: He was 17 or 18 when he left. I think he was probably naive about it and he really missed Gaza.

Despite a cease-fire, there will still be widespread health devastation in Gaza, with countless people now unable to access the meds and treatment they need for either pre-existing or post-October 7 conditions, everything from various infections to malnutrition to mental trauma. What do you think will happen?

Nessouli: I think many people there are hoping after a cease-fire to evacuate and get to Cairo or elsewhere for health care. I’ve also spoken to doctors and health workers in Gaza who have no plans of leaving ever, because they feel a duty and a responsibility to what comes next. But I think for most people, the realistic choice is to get out and go elsewhere for help.

I’ll keep up with E.S. Right now, he’s concentrating on what to do next.