HIV among African-born persons in the United States: a hidden epidemic?
BACKGROUND
Although a large proportion of HIV diagnoses in Western Europe occur in African-born persons, analyses of US HIV surveillance data do not routinely assess the proportion of diagnoses occurring in African-born US residents.


OBJECTIVE
To determine the percentage of newly reported HIV diagnoses occurring in African-born persons in selected areas of the United States with large African-born immigrant populations.


METHODS
We collated and analyzed aggregate data on persons diagnosed with HIV in 2003-2004 and reported to HIV surveillance units in the states of California, Georgia, Massachusetts, Minnesota, and New Jersey and in King County, Washington; New York City; and the portion of Virginia included in the Washington, DC, metropolitan area.


RESULTS
African-born persons accounted for 0.6% of the population and 3.8% of HIV diagnoses in participating areas (HIV diagnoses range: 1%-20%). Across all areas, up to 41% of diagnoses in women (mean: 8.4%, range: 4%-41%) and up to 50% of diagnoses in blacks (mean: 8.0%, range: 2%-50%) occurred among African-born individuals.


CONCLUSIONS
In some areas, classifying HIV cases among foreign-born blacks as occurring in African Americans dramatically alters the epidemiological picture of HIV. Country of birth should be consistently included in local and national analyses of HIV surveillance data.
Kerani
Roxanne P
RP
Public Health - Seattle & King County, Harborview Medical Center, Seattle, WA 98104, USA. rkerani@u.washington.edu
Kent
James B
JB
Sides
Tracy
T
Dennis
Greg
G
Ibrahim
Abdel R
AR
Cross
Helene
H
Wiewel
Ellen W
EW
Wood
Robert W
RW
Golden
Matthew R
MR
D001741:Black or African American; D004196:Disease Outbreaks; D004641:Emigration and Immigration; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D008297:Male; D014481:United States / Q000453:epidemiology