Characteristics of foreign-born HIV- infected individuals and differences by region of origin and gender
M. Carten, J. Castillo-Mancilla, S. Johnson
University of Colorado Denver, Division of Infectious Disease, Aurora, United States
Background: Little data exist on US foreign-born (FB) HIV populations; however, differences may exist between US-born and FB HIV+ persons and by Region of Origin (ROO) and gender.
Methods: This was a retrospective chart review of FB HIV-infected patients in a university-based HIV program in Colorado, USA. Patient demographic data and clinical parameters were summarized descriptively for entire FB population. Further analysis was performed by ROO (Africa, Latin-America/Caribbean [LAC], Asia, and Europe) and gender with summary comparisons made between groups.
Results: 146 FB HIV+ individuals were identified representing 10% of the HIV clinic population. The mean age was 39.8 years and 40% were women. ROO included 47% LAC, 42% Africa, 8% Asia and 3% Europe; 19% were known to be refugees with 92% from Africa. Africa was ROO for 61% of women and 29% of men; Heterosexual sex ( HT) was HIV risk factor for 68%, MSM for 22% and blood transfusion/needle stick for 3%. HT was risk factor for 92% of Africans, 60% of Asians, 54 % of LAC, 89% women, and 55 % men. HIV test reason (n=118) was illness in 43%, immigration in 26%, partner-positive in 14% and pregnancy in 9%. HIV test reason was immigration in 49% of Africans and 39% women (39%), and illness for 61 % of LAC and 46% men. An opportunistic infection diagnosis (n=119) was present in 24%, and 12% of pts had a mental health diagnosis (n=102). Mean CD4 cell count (n=101) was 542 cells/ml and antiretroviral use (n=104) was present in 89%.
Conclusions: FB HIV+ patients represent a substantial proportion of US HIV clinical programs. Important differences exist between FB pts by region of origin and gender. HIV care and prevention programs must address these dissimilarties in order to maximize patient outcomes and optimize allocation of resources.
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