Non-Israeli migrants and HIV in Israel: The Tel-Aviv CRUSAID Kobler AIDs center experience

Jewish immigrants to Israel are automatically entitled to the status and full rights of citizenship, including comprehensive medical care mandated by national health insurance non-Israeli migrants (NIMs) do not carry health insurance that covers pathoses related to HIV. Their healthcare is provided mostly by voluntary health services. We wanted to characterize the NIMs who attended the HIV clinic in the Tel-Aviv Medical Center between 1996 to 2009. Study group: All NIMs diagnosed as being infected by HIV and treated in our services during the study period. Methods: Data on demographics and selected clinical parameters were collected from the NIMs medical files and analyzed. Results: Of the 960 patients followed between 1996-2008 in our outpatient clinic, 242 (25.2%) were non-Israeli citizens. The majority of them originated from Africa (71%), mostly from west and east Africa. The median time from arrival to Israel until the diagnosis of HIV was 3 years. Tuberculosis and hepatitis B were diagnosed mostly in patients of African origin, while hepatitis C was diagnosed mostly in patients from Eastern Europe. Antiretroviral therapy was started at a CD4 cell count level lower than that of the general population in Israel. Only 15 of the 30 women who were pregnant were treated by combination antiviral therapy during pregnancy, and four babies born to the 24 non-treated pregnant women were infected by HIV. Conclusions: A weak population lives among Israeli citizens and the inequity of medical care available to them. However, pregnant women and their newborns are getting the same level of care as Israelis.