Migration pathways and HIV: Studying prevalence of the disease amongst refugee and non-refugee immigrant mothers in Canada

By Ana Gajic

Refugee mothers who reside in a transitional country prior to coming to Canada are more likely to have HIV compared to refugee mothers who come to Canada directly, suggests a new study published this week in AIDS Care.

Led by Dr. Susitha Wanigaratne, a post-doctoral fellow at the MAP Centre for Urban Health Solutions and ICES, the research aimed to identify whether both refugees and non-refugees who reside in a transition country prior to coming to Canada – known as ‘secondary migrants’ – are more likely to have HIV compared to refugees and non-refugees who come to Canada directly, often called ‘primary migrants.’

“For refugees who initially seek asylum in a transition country, limited formal and informal social protection may increase the risk of contracting HIV,” Dr. Wanigaratne said. “Non-refugee immigrants who are employed in unskilled and unregulated jobs in transition countries with poor pay and no health benefits may also be at risk of HIV. For both groups, residing in a transition country may be an indicator of prolonged marginalization leading to a higher risk of HIV.”

The research team found that refugees with secondary migration were 68 per cent more likely to have HIV compared to refugees with primary migration. There was no difference between non-refugees with secondary and primary migration.

“This study suggests secondary migration is an important determinant of HIV among refugee women in Canada,” Dr. Wanigaratne said.

It may be beneficial, she suggests, for HIV screening guidelines to include refugee status as an indicator.

“It is important for health-care providers in Canada to be aware of the needs of refugees with secondary migration and address any barriers they may face in accessing HIV treatment, care and support stemming from HIV-related stigma and discrimination,” she said.

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