HIV infection in refugees: a case-control analysis of refugees in Rhode Island

Int J Infect Dis. 2009 Mar;13(2):186-92. doi: 10.1016/j.ijid.2008.06.004. Epub 2008 Sep 3.


Objectives: The number of HIV-infected refugees entering the USA is increasing. There is little data describing the HIV-infected refugee population and the challenges encountered when caring for them. We performed a retrospective case-control analysis of HIV-infected refugees in order to characterize their co-morbidities, baseline HIV characteristics, and longitudinal care compared to HIV-infected non-refugees.

Methods: A retrospective chart review was performed of HIV-infected refugees and non-refugees who were matched for gender, age, and time of establishment of initial HIV care.

Results: The refugee population studied was largely from West Africa. Refugees were more likely than non-refugees to have heterosexual risk for HIV infection, latent tuberculosis infection, and active hepatitis B. Refugees were less likely than non-refugees to have a history of substance use, start antiretrovirals, and be enrolled in a clinical study. The baseline CD4 counts and HIV plasma viral loads were similar between the two groups.

Conclusions: Clinicians caring for West African HIV-infected refugees should be knowledgeable about likely co-morbidities and the impact of cultural differences on HIV care. Further studies are needed to develop culturally competent HIV treatment, education, and prevention programs for refugees who are beginning a new life in the USA.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Africa, Western
  • Anti-HIV Agents / therapeutic use
  • CD4 Lymphocyte Count
  • Case-Control Studies
  • Delivery of Health Care
  • Female
  • HIV Infections* / complications
  • HIV Infections* / drug therapy
  • HIV Infections* / epidemiology
  • HIV Infections* / virology
  • HIV-1* / isolation & purification
  • HIV-1* / physiology
  • Hepatitis B / complications
  • Hepatitis B / epidemiology
  • Heterosexuality
  • Humans
  • Male
  • Middle Aged
  • RNA, Viral / blood
  • Refugees / statistics & numerical data*
  • Rhode Island / epidemiology
  • Risk Factors
  • Tuberculosis / complications
  • Tuberculosis / epidemiology
  • Viral Load


  • Anti-HIV Agents
  • RNA, Viral