BACKGROUND: Refugees represent a population vulnerable to HIV infection and other diseases. Identifying HIV infection has implications for the individual refugee, the clinical provider, and the public health system. The objective of this study was to assess the demographic and clinical characteristics of adult refugees in Houston, Texas who tested positive for HIV as a part of post-arrival medical screening and care.
METHODS: Data used for this analysis were obtained from individuals who tested positive for HIV during medical screening conducted by the Harris County Public Health Refugee Health Screening Program and reported to the Houston Health Department (HHD) between 2012 and 2016. A total of 103 cases were identified during the period. Measures assessed include demographics (age, age groups, gender, race/ethnicity, country of origin, years of residency in Houston following diagnosis, and geographic distribution) and clinical characteristics (transmission risk category and disease stage). Data obtained were subjected to both descriptive and inferential statistics using SAS version 9.4 (SAS Institute, Cary, NC, USA).
RESULTS: The average age of HIV-infected individuals in the cohort was 36 (95%CI: 34-38) years with gender distribution of 66% male and 34% female. The majority of the individuals were males (66%), with 29% and 25% reporting MSM and no identified risk/no reported risk (NIR/NRR) transmission risk, and 34% females with 26% NIR/NRR and 8% Heterosexual transmission risk (p<.0001). Overall, Hispanics made up 59% of the cases with 29% and 25% identified as MSM and NIR/NRR risk groups (p<.0001). The majority HIV-infected persons were from Latin America (57%) followed by, Africa (26%) and Asia (17%) (p<.0001). Eighty-five percent (85%) of the individuals were diagnosed with HIV and 15% with AIDS (p<.0001). Forty-nine percent (49%) and 51% of individuals diagnosed have resided in Houston for at least 1 and 2-4 years. Sixty-one percent (61%) and 24% of the individuals were living in the South West and North West geographic area of Houston (p<.0001) at the time of diagnosis.
CONCLUSIONS: Our findings indicate that HIV-infected individuals with NIR/NRR were younger adults with 52% of them with NIR/NRR risk of transmission. Consequently, efforts are needed from the health care system to formulate targeted strategies to obtain better and complete medical screening information that could assist with risk-reduction counseling, especially for sexually active individuals.