High seroprevalence rates among foreign-born men undergoing rapid HIV testing in Philadelphia
H. Kwakwa1, A. Nunn2, C. Bettigole1, L. Dean1, A. O'Donnell3, T. Flanigan2
1Philadelphia Department of Public Health, Ambulatory Health Services, Philadelphia, United States, 2Brown University School of Medicine, Infectious Diseases, Providence, United States, 3Haverford College, Haverford, United States
Background: Few data are available about HIV testing and prevalence rates among foreign-born populations in the US. Philadelphia introduced a rapid HIV testing campaign in its public health clinics in 2007 and has tested over 12,000 individuals since the program's inception. This study examines HIV testing and seroprevalence rates of a non US-born population undergoing rapid HIV testing in Philadelphia's public health clinics between July 2007 and December 2009.
Methods: Individuals seeking care at the walk-in clinics of the Philadelphia Health Department between July 2007 and December 2009 were offered rapid HIV testing and counseling. We collected data on patient demographics, country of origin and HIV testing history among the 12,483 individuals.
Results: Of 12,483 individuals tested, 2,217 (18%) were foreign born. Among foreign-born individuals, HIV prevalence rates were 0.6%, compared to 1.1% among Americans. Approximately 469 (21%) of foreign-born testers were African, 583 (26%) were Asian, 748 (34%) were Caribbean, and 297 (13%) were from Central or South America. More than half of all individuals testing were female, including 52% of Americans, and 68% of foreign-born individuals tested. Nearly 77% of Africans and 75% of Americans compared to only 41% of Asians reported ever having been tested for HIV. Seroprevalence rates were 2.4% among Caribbean men and 0.2% among Caribbean women, 1.5% among African men and 0.4% among African women, and lowest among Central and South Americans (0.3%, n=297) and Asians (0%, n=573).
Conclusions: HIV testing and seroprevalence rates among foreign-born individuals in Philadelphia differ by country of origin; Caribbean men and African men in Philadelphia are at highest risk for contracting HIV, with 2.4 and 1.5 times higher risk of testing HIV positive than Americans in Philadelphia. These findings suggest that “seek and treat” strategies should be tailored to each unique foreign-born community, and should be gender-specific.
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