Akinsete Omobosola O, Sides Tracy, Hirigoyen Diane, Cartwright Charles, Boraas Christy, Davey Cynthia, Pessoa-Brandão Luisa, McLaughlin Mary, Kane Ellen, Hall Jane, Henry Keith
University of Minnesota/HIV Program Hennepin County Medical Center, Minneapolis, Minnesota 55405, USA.
AIDS Patient Care STDS. 2007 May;21(5):356-65. doi: 10.1089/apc.2006.0074.
Minnesota is currently home to the tenth largest African population and the second largest East African population in the United States. HIV is increasingly being diagnosed in African-born persons in Minnesota. A retrospective survey was conducted on all African-born patients in our HIV clinic between January 1994 and June 2005. We identified 237 patients who were African-born and HIV-positive. They constituted 12% of patients attending the clinic within the study timeframe. There was no significant difference in the ages of the African-born and non-African patients in the HIV clinic. African-born patients were more likely to be women compared with non-African patients (p < 0.001). Forty-three percent of the African-born patients presented with AIDS as defined by CD4(+) T cell counts less than 200 cells per milliliter compared to 33% of antiretroviral naïve non-African HIV patients in the clinic (p < 0.001). Most patients were infected through heterosexual contact and only 4% were diagnosed as a result of routine testing. Seven known HIV subtypes and four unique recombinant forms were identified. The most common opportunistic infection was pulmonary tuberculosis. African immigrants with HIV appear to: (1) access care at later stages of HIV disease than other patients in our clinic; (2) are often infected with non-B subtypes; (3) do not routinely get tested for HIV. Increased awareness to this growing trend is needed for health care providers and public health officials to tailor educational programs and prevention efforts for African immigrants in the United States.
明尼苏达州目前是美国非洲裔人口数量排名第十、东非裔人口数量排名第二的聚居地。在明尼苏达州，越来越多出生于非洲的人被诊断出感染了艾滋病毒。我们对1994年1月至2005年6月期间在我们艾滋病诊所就诊的所有出生于非洲的患者进行了一项回顾性调查。我们确定了237名出生于非洲且艾滋病毒呈阳性的患者。他们占研究时间段内诊所就诊患者的12%。艾滋病诊所中出生于非洲的患者与非非洲患者的年龄没有显著差异。与非非洲患者相比，出生于非洲的患者更有可能是女性（p < 0.001）。43%的出生于非洲的患者出现了艾滋病相关症状，其定义为每毫升血液中CD4(+) T细胞计数低于200个，而诊所中初治的非非洲艾滋病毒患者这一比例为33%（p < 0.001）。大多数患者是通过异性接触感染的，只有4%是因常规检测而被诊断出感染。我们识别出了7种已知的艾滋病毒亚型和4种独特的重组形式。最常见的机会性感染是肺结核。感染艾滋病毒的非洲移民似乎：（1）比我们诊所的其他患者在艾滋病病程较晚阶段才开始接受治疗；（2）经常感染非B亚型；（3）没有定期进行艾滋病毒检测。医疗保健提供者和公共卫生官员需要提高对这一增长趋势的认识，以便为美国的非洲移民量身定制教育项目和预防措施。
