Abstract
Background: As we strive to reduce disparities in the implementation of the US National HIV/AIDS Strategy, we must understand HIV disparities as they exist in all US populations, including the foreign-born. We evaluate disparities in HIV prevalence in a US and foreign-born cohort in Philadelphia. Methods: Comparative analyses were conducted using data from questionnaires paired with HIV test results for individuals undergoing HIV testing in Philadelphia between 2007 and 2011. Descriptive analyses were conducted by gender and world region of origin. Results: Of 14,216 participants, 76.2% were US-born and 59% female. Caribbean men, 3.6% of the cohort, constituted 11.4% of the HIV- positive. Among women, Africans, 3.0% of the cohort constituted 4.5% of the HIVpositive. No disparities by race/ethnicity were found in the US-born cohort. Conclusions: In this global population in Philadelphia, HIV disparities were found to occur by world region of birth and gender. The foreign-born must be included in analyses of the domestic epidemic that drive prevention strategies, policy and resource allocation
Highlights
Of the estimated 1.1 million individuals living with HIV in the US, [1] a significant and growing percentage is foreign-born [2,3]
While analyses of disparities in the impact and prevalence of HIV have been integral to our understanding of the domestic epidemic, the US-resident foreign-born are seldom included in such analyses as a distinct group
The US resident foreign-born population studied in this paper shows patterns of HIV epidemiology reflective of neither their countries of origin nor the US, suggesting that they should perhaps be regarded as a third group with their HIV prevalence informed in part by factors from their country of origin, and in part by realities in their adopted country
Summary
Of the estimated 1.1 million individuals living with HIV in the US, [1] a significant and growing percentage is foreign-born [2,3]. In the first published national analysis of the foreign-born population in the US with HIV, conducted in 46 states between 2007 and 2010 the foreignborn constituted 16.2% of the HIV-positive person ( they accounted for 13% of the US population overall). While analyses of disparities in the impact and prevalence of HIV have been integral to our understanding of the domestic epidemic, the US-resident foreign-born are seldom included in such analyses as a distinct group. The growing population of the foreign-born must factor into our approaches to all aspects of the 2015 National HIV/AIDS Strategy, [5] including reducing disparities and health inequities. As we strive to reduce disparities in the implementation of the US National HIV/AIDS Strategy, we must understand HIV disparities as they exist in all US populations, including the foreign-born. We evaluate disparities in HIV prevalence in a US and foreign-born cohort in Philadelphia
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