A retrospective cohort study of Ukrainian beneficiaries of temporary protection living with HIV attending an Irish tertiary care service

OBJECTIVES: To describe the demographic, clinical and healthcare utilization characteristics of Ukrainian beneficiaries of temporary protection living with HIV (UBOTPLWH) attending an Irish tertiary HIV service and to assess the impact of individual barriers to care on virological outcomes and retention in care. METHODS: We performed a retrospective observational cohort study of adult UBOTPLWH enrolled in an outpatient HIV service in Cork University Hospital, Ireland, between February 2022 and April 2025. Data were extracted from clinical and laboratory records. Descriptive statistics summarized demographics, HIV parameters, antiretroviral therapy (ART), co-infections and healthcare utilization. Exploratory analyses assessed associations between individual barriers to care and clinical outcomes. RESULTS: Fifty-nine patients were included; 59.3% were female and median age was 44 years (interquartile range [IQR] 39-51 years). Most (84.7%) had a known HIV diagnosis prior to arrival, with a median duration of diagnosis of 10 years. At enrolment, 66.7% were virologically suppressed (<50 copies/mL) and median CD4 count was 561 cells/μL. Prior opportunistic infection was reported in 25.0% of the 48 patients for whom such data were available. ART regimens were frequently modified following enrolment, particularly among those receiving tenofovir disoproxil fumarate/lamivudine/dolutegravir prior to migration. At the most recent follow-up, viral load data were available for 49 participants, of whom 87.8% were suppressed. Barriers to care were common, including interpreter requirement (64.4%), geographic dispersion (median distance 54 km) and residential instability. In exploratory analyses, detectable viral load at enrolment was associated with missed clinic attendance (p = 0.019), while viral non-suppression at follow-up was associated with hospital admission (p = 0.007) and missed clinic attendance (p = 0.047). CONCLUSIONS: Despite timely linkage to care and preserved immune status at enrolment, UBOTPLWH in Ireland experience substantial structural barriers that may adversely affect engagement and virological outcomes. Tailored, accessible service models are required to support displaced populations living with HIV.