HIV infection in refugees: a case-control analysis of refugees in Rhode Island.
OBJECTIVE
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.
Beckwith
Curt G
CG
The Miriam Hospital, Providence, Rhode Island, USA. CBeckwith@Lifespan.org
DeLong
Allison K
AK
Desjardins
Simon F
SF
Gillani
Fizza
F
Bazerman
Lauri
L
Mitty
Jennifer A
JA
Ross
Heather
H
Cu-Uvin
Susan
S
D000328:Adult; D000354:Africa, Western; D019380:Anti-HIV Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D003695:Delivery of Health Care; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification / Q000502:physiology; D006509:Hepatitis B / Q000150:complications / Q000453:epidemiology; D020010:Heterosexuality; D006801:Humans; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D012036:Refugees / Q000706:statistics & numerical data*; D012237:Rhode Island / Q000453:epidemiology; D012307:Risk Factors; D014376:Tuberculosis / Q000150:complications / Q000453:epidemiology; D019562:Viral Load
D019380:Anti-HIV Agents; D012367:RNA, Viral
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