Comparison of HIV/AIDS Rates Between U.S.-Born Blacks and African-Born Blacks in Utah, 2000 – 2009

Abstract

The Utah Department of Health currently groups African-born blacks with U.S.-born blacks when reporting HIV/AIDS surveillance data. Studies suggest that categorizing HIV/AIDS cases in this manner may mask important epidemiological trends, and the distinct differences between these two populations warrant disaggregating data prior to reporting. The purpose of this study was to characterize the HIV/AIDS positive populations in U.S. and African-born blacks in Utah and evaluate the need for disaggregating the two groups. A total of 1,111 cases were identified through the statewide electronic HIV/AIDS Reporting System from 2000 - 2009. Data were analyzed for prevalence of HIV diagnosis for African-born blacks, U.S.-born blacks, and U.S.-born whites. Secondary analysis included HIV diagnosis by age, sex, African region of nativity, transmission risk factors, and differences in late diagnosis of HIV infection. U.S.-born whites accounted for 914 (82.3%) cases, and had the lowest annual prevalence (4/100,000). Conversely, African-born and U.S.- born blacks had the highest prevalence, 162/100,000 and 24/100,000 respectively. African-born blacks made up 0.25% of the total population, but accounted for 7.9% of all HIV/AIDS cases. African-born black males were more likely to report “no reported risk” for HIV transmission than U.S.-born black males. Of African-born blacks, 55.7% reported East-African nativity. These results demonstrate the importance of stratifying the black/African American racial category by African-born and U.S.-born blacks when collecting and reporting HIV/AIDS state surveillance data even in a low-incidence state,which will better inform prevention and linkage-to-care efforts in Utah.

Differences Between U.S.-Born and Non-U.S.-Born Black Adults Reported with Diagnosed HIV Infection: United States, 2008–2014

“…Compared with U.S.-born Black adults, non-U.S.-born Black adults were more likely to be female, receive their diagnosis at an older age, acquire HIV infection through heterosexual contact, and have infection classified as AIDS ≤ 3 months after initial HIV diagnosis. These findings are consistent with previous national [4,21] and local level studies [5,22]. Non-U.S.-born Black adults had higher diagnosis rates than U.S.-born Black adults consistent with previous findings [4].…”

Evidence of Local HIV Transmission in the African Community of King County, Washington

“…There is increasing recognition of the disproportionately large impact of HIV on African-born residents of the U.S. 1–4 Previous studies and surveillance data suggest that the HIV epidemic among African-born people in the U.S. reflects the epidemic in Africa: primarily heterosexual transmission, with a much larger proportion of HIV-infected women than has been observed in other populations in the U.S. 1–6 While many HIV-infected African people diagnosed in the U.S. were likely exposed to HIV before arriving in this country, data from Western Europe suggest that there is some level of local transmission within African migrant destination countries, including the U.S. 7–10 Molecular epidemiology can complement clinical and surveillance data to provide additional insight into the region of HIV exposure. 11,12 We undertook the current study both to estimate the degree of local HIV transmission in newly diagnosed African-born people reported with HIV, and to describe HIV testing patterns in this population, in King County (KC), WA.…”