Author(s): Prosser AT, Tang T, Hall HI
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Abstract CONTEXT: Persons born outside the United States comprise about 13\% of the US population, and the challenges these persons face in accessing health care may lead to poorer human immunodeficiency virus (HIV) disease outcomes. OBJECTIVE: To describe the epidemiology of HIV among persons born outside the United States and among US-born persons diagnosed in the United States. DESIGN, SETTING, AND PARTICIPANTS: Analysis of the estimated number of US-born persons and persons born outside the United States diagnosed with HIV from 2007 through 2010 in 46 states and 5 US territories, the demographic characteristics, and the HIV transmission risk factors reported to the National HIV Surveillance System. Foreign-born persons were defined as persons born outside the United States and its territories, inclusive of naturalized citizens. MAIN OUTCOME MEASURE: Diagnosis of HIV infection. RESULTS: From 2007 through 2010, HIV was diagnosed in 191,697 persons in the US population; of these, 16.2\% (95\% CI, 16.0\%-16.3\%) (n = 30,995) were born outside the United States. Of the 25,255 persons with a specified country or region of birth outside the United States, 14.5\% (n = 3656) were from Africa, 41.0\% (n = 10,343) were from Central America (including Mexico), and 21.5\% (n = 5418) were from the Caribbean. The 4 states (California, Florida, New York, and Texas) reporting the highest numbers of persons born outside the United States and diagnosed with HIV were also the top 4 reporters of HIV cases overall. Among persons born outside the United States with HIV, 73.5\% (n = 22,773) were male. Among whites, 1841 of 55,574 (3.3\%) of HIV diagnoses were in persons born outside the United States; in blacks, 8614 of 86,547 diagnoses (10.0\%); in Hispanics, 17,913 of 42,431 diagnoses (42.2\%); and in Asians, 1987 of 3088 diagnoses (64.3\%). The percentage infected through heterosexual contact was 39.4\% among persons born outside the United States vs 27.2\% for US-born persons. CONCLUSIONS: Among persons in 46 US states and 5 US territories who received a diagnosis of HIV from 2007 through 2010, 16.2\% were born outside the United States. Compared with US-born persons diagnosed with HIV, persons born outside the United States had different epidemiologic characteristics.
This article was published in JAMA
and referenced in Journal of AIDS & Clinical Research