Massachusetts: Cases of HIV on Rise Among Immigrants

The proportion of HIV cases among the foreign-born in Massachusetts has grown from 18 percent of HIV diagnoses in 1999 to 26 percent in 2004, according to the state Department of Public Health (DPH). These figures represent all categories of immigrants, including refugees and asylum seekers.

From 2002 to 2004, 785 foreign-born persons were diagnosed with HIV, or 28 percent of diagnoses for that period. The majority of diagnoses were in people from sub-Saharan Africa, the Caribbean, and Central and South America, DPH figures show.

For some asylum seekers who cross the border without first attaining refugee status, their initial HIV diagnosis may be made when attempting to file evidence for their immigration application. Asylum seekers must prove past persecution or threat of persecution based on race, religion, nationality, political opinion, or social grouping.

In a 2003 letter to the Journal of Acquired Immune Deficiency Syndromes, staff at Boston Medical Center's Center for Refugee Health and Human Rights documented that 77 percent of 34 HIV-positive patients had been tortured in their home country. Thirty-five percent were exposed to HIV through that torture, they said.

"Some of our clients that have been imprisoned for their political activities, like demonstrating in favor of democracy, have been repeatedly raped while in prison," said Sarah Ignatius, executive director of the Boston-based Political Asylum/Immigration Representation Project. "When they came to the U.S., they have learned that they were HIV-positive."

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