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Global Refugees Checklist
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Overview of HIV

Immigrants and refugees from countries with high prevalence of HIV (>1%) are vulnerable because of the high HIV prevalence in their home countries and because of high levels of HIV-related stigma that often persists in their Canadian communities.  Refugees and refugee claimants may delay testing and/or treatment because of lack of knowledge of effective treatments, or because they fear failing to obtain legal immigration status if HIV-positive:

Key Recommendations:

*> 1% HIV = sub-Saharan Africa, Caribbean, Thailand

Quality of Evidence: MODERATE

Balance of benefits and harms Values and preferences
  • Prevalence of HIV infection is higher among immigrants from countries where HIV is prevalent (> 1%) than among other Canadians (< 0.18%).
  • The decision to screen men and women for HIV is based on a dramatic reduction in mortality with treatment, e.g., with a combination of three versus two antiretrovirals (NNT 132, 95% CI 91–357) and reduction of high-risk behaviour (NNT 5, 95% CI 4–7).
  • Harms included adverse drug reactions requiring change in regimen.
  • Data on harms related to anxiety and possible discrimination related to HIV status are unavailable.

The committee attributed more value to:

  • Identifying HIV-positive women and men for appropriate treatment, support and prevention

Attributed less value to:

  • Uncertain risk of couple discord and risk of discrimination
  • Burden of testing with informed consent

Links to Other Learning Resources

Design and Production: Centre for e-Learning, Teaching and Learning Support Service (TLSS), University of Ottawa