The limited studies addressing the health of African Immigrants(AI)  have focused on infectious diseases8. Because there are significant gaps in knowledge on AIs in the U.S., we will also draw from studies conducted in Europe and elsewhere to supplement our understanding of HIV/AIDS, Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), and Tuberculosis (TB) among AIs in the subsequent discussion. 

AIs have lower rates of HIV infection than AAs, but rates of infection and mortality are increasing8. In a study conducted in Minneapolis, MN, 30% of the newly diagnosed patients were AIs; they were present at later stages of the disease and had less knowledge about HIV13. In Maryland, 2,914 of the 30,566 persons living with diagnosed HIV through 2017 were foreign-born. African-born residents account for 6.0% of the total persons living with HIV and 62.7% of the foreign-born cases. African-born persons living with HIV were born in 39 countries, with the largest numbers born in Cameroon (26.5%), Ethiopia (16.1%), Nigeria (12.5%), and Kenya (6.5%). 

The Maryland Department of Health surveillance data shows of the 1,040 new HIV diagnoses in Maryland in 2017, 150 were foreign-born adults/adolescents, and a staggering 99 or 66% of those diagnosed with HIV in 2017 were born in Africa.13a In Harawa et. al. study in Los Angeles, CA, most of the AIs were infected after their arrival in the U.S.14 HIV awareness and knowledge have also been found to be low, and stigma high, among AIs in Houston15, TX. AIs have also reported fear concerning the U.S. healthcare system, stigma regarding HIV transmission, legal, and linguistic challenges to engaging with the health care system. A review by Blanas et al.16 highlighted the growing rate of HIV among AIs and called for improved surveillance and more accurate epidemiologic data. Furthermore, Koku et al17 have called for more accurate and disaggregated epidemiologic data on AIs to address the goals of the U.S. National HIV/AIDS Strategy.