US citizens born outside of US more likely to have HIV vs. those born in US

When compared with US-born citizens with HIV, Asians and Hispanics born outside of the United States were the most likely group to be diagnosed with HIV while residing in the United States. Heterosexual contact was the most likely cause of HIV acquisition among these two groups.

Seventy-eight percent of cases were among US-born males vs. 74% of cases that occurred among males born outside of the United States, according to data published in the Journal of the American Medical Association presented during a press briefing at the 2012 International AIDS Conference.

A team of researchers, led by Irene Hall, PhD, of the CDC, set out to compare the differences in demographic, geographic and risk factor characteristics between those citizens born in the United States and among those born outside of the United States diagnosed with HIV while residing in the country between 2007 and 2010.

Irene Hall, PhD

“Knowledge of the local population at risk for HIV infection is important for appropriate targeting of prevention efforts,” Hall told Infectious Disease News. “The regional distribution of persons born outside the US shows differences in the distribution of world region of origin in populations that need to be reached with HIV testing and prevention messages.”

The study included data from the National HIV Surveillance System for 46 states and five US territories.

Of the 191,697 confirmed HIV diagnosis between 2007 and 2010, 16.2% (n=30,995) of cases were in those born outside of the United States. California, Florida, New York and Texas had the highest reported cases of HIV overall and the most cases reported in those born outside of the United States.

When the researchers looked at cases among specific race/ethnicities, they found that 64.3% of all HIV diagnoses in Asians were in those born outside of the United States; 42.2% of all diagnoses in Hispanics were in those born outside of the United States; 10% of all diagnoses in blacks were in those born outside of the United States; and 3.3% of all diagnoses in whites were in those born outside of the United States.

Central America was the most common region of birth origin among those with HIV born outside of the United States (41%). This was followed by the Caribbean (21.5%), Africa (14.5%), Asia (7.9%) and South America (7.6%).

“CDC recommends that all people know their HIV status, and it is important to include testing in routine care,” Hall said. “Often people do not perceive themselves to be at risk for HIV, especially women. They need to be offered routine HIV testing. In addition, persons born outside the US may have challenges accessing health care. Making sure they have access to testing and linking them to care and assuring continuous care and treatment are essential to improve their health and reduce the potential for onward transmission of HIV.”

“Future analyses need to determine whether after the lifting of the immigration exclusion there are changes in the epidemiology of HIV among persons born outside the US, including children (which may reflect international adoptions). We also need to track whether persons born outside the US have disparities in linkage to care, retention in care and viral suppression.”

References:

Prosser AT. JAMA. 2012. doi:10.1001/jama.2012.9046.

Also presented at: XIX International AIDS Conference; July 22-27; Washington, D.C.

Disclosures:

The researchers report no relevant financial disclosures.