AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #226 - West Indian immigrants in NYC: Disentangling HIV/AIDS surveillance data for comparisons with other Caribbean immigrants and US-born Blacks and Whites
Authors: Presenting Author: Dr. Susie Hoffman - NYS Psychiatric Institute and Columbia University
Additional Authors: Mr. Yusuf Ransome, Dr. Jessica Adams-Skinner, Dr. Cheng-Shiun Leu,
Aim: Often assumed but untested is that immigrants to the US, especially Black and Latino immigrants, are at elevated risk for HIV and other STIs. West Indian (WI) immigrants, the majority of whom are Black, originate from the 18 English-speaking Caribbean basin countries and constitute one of the largest immigrant populations in NYC and other Eastern seaboard cities. Despite the size and cultural significance of this immigrant group, their HIV surveillance statistics are not routinely disaggregated from those of other Caribbean immigrants nor compared with those of US-born residents. To advance research into how the social processes of migration, settlement, and acculturation influence sexual health—and HIV/AIDS in particular—we calculated crude and age-adjusted rates of new HIV diagnoses and PLWHA for three groups of Caribbean immigrants and native-born Blacks and Whites.
Method / Issue: We used 2007 HIV surveillance data from the NYC Department of Health and Mental Hygiene and population data from the US Census American Community Survey 2007 to calculate crude and age-adjusted rates of newly-reported HIV diagnoses and people living with HIV/AIDS (PLWHA) for three groups of Caribbean immigrants in NYC – those from English-speaking, Spanish-speaking, and French- and Dutch-speaking nations – and for US-born NYC Blacks and Whites.
Results / Comments: WI immigrants had an age-adjusted rate of newly-reported HIV diagnoses of 38.09 per 100,000 population (95% CI=34.47, 42.84). This rate was higher than the rate in US-born Whites (16.99; 95% CI = 15.86, 18.19) and lower than that in US-born Blacks (101.94; 95% CI = 97.79, 106.24). The rate of newly-reported HIV diagnoses in WI immigrants was similar to that in immigrants from the Spanish-speaking Caribbean (31.30; 95% CI = 27.66, 35.82) and considerably lower than the rate in immigrants from the French- and Dutch-speaking Caribbean (68.32; 95% CI = 55.86, 85.63). Considering PLWHA, WI immigrants had a prevalence that was lower than that of all other groups except immigrants from the Spanish-speaking Caribbean. In contrast to the data for newly-reported HIV diagnoses, the prevalence of PLWHA among WI immigrants was lower than the prevalence among US-born Whites.
Discussion: Our findings are consistent with those of Wieval et al., who found that foreign-born NYC Black men had a lower rate of newly-reported HIV diagnoses and a lower prevalence of PLWHA than native-born Black men. Our findings also highlight the need to consider the contexts of migration to understand differences in rates of reported HIV among immigrant groups and between immigrants and native-born populations. To build theory around migration and sexual health and to inform the development of prevention interventions, we need to understand how the structural aspects of WI migration shape immigrants’ experiences, how these experiences compare with those of other global immigrants, and in particular the role that race assumes for foreign- and native-born Blacks in creating risk for and protection from HIV/AIDS.
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