Public Health-Seattle and King County, University of Washington, 401 Fifth Ave, Ste 900, Seattle, WA 98104, USA.
J Natl Med Assoc. 2009 Dec;101(12):1230-6. doi: 10.1016/s0027-9684(15)31134-2.
To describe the characteristics of human immunodeficiency virus (HIV)-infected black African immigrants living in King County, Washington, we evaluated delay in HIV diagnosis, access to HIV care, and risk of progression to AIDS or death.
We compared differences in the risk of progression to AIDS or death between HIV-positive African-born black individuals and 2 groups of HIV-positive US-born individuals.
There were significant differences across the groups in residence at time of HIV diagnosis, gender, HIV transmission category, and initial CD4 count. Black Africans were more likely to present with an AIDS diagnosis (45%), compared to both US-born nonblacks (25%) and US-born blacks (35%). No significant independent associations were observed in rates of HIV disease progression when black African immigrants were compared to their US-born counterparts.
Once having initiated HIV care, African-born blacks accessed HIV care and progressed to AIDS at similar rates compared to US-born individuals. However, African-born blacks initiated care with more advanced HIV disease. Results underscore the need for health interventions promoting HIV testing among black African immigrants and reducing barriers to HIV testing.
为了描述居住在华盛顿州金县的感染人类免疫缺陷病毒（HIV）的黑人非洲移民的特点，我们评估了 HIV 诊断的延迟、获得 HIV 护理的机会以及进展为艾滋病或死亡的风险。
我们比较了 HIV 阳性的非洲出生黑人个体与 2 组 HIV 阳性的美国出生个体在进展为艾滋病或死亡的风险方面的差异。
在 HIV 诊断时的居住地、性别、HIV 传播类别和初始 CD4 计数方面，各组之间存在显著差异。与美国出生的非黑人（25%）和美国出生的黑人（35%）相比，黑人非洲人更有可能出现艾滋病诊断（45%）。当将非洲出生的黑人移民与他们的美国出生的同龄人进行比较时，未观察到 HIV 疾病进展率的显著独立关联。
一旦开始接受 HIV 护理，非洲出生的黑人获得 HIV 护理并进展为艾滋病的速度与美国出生的个体相似。然而，非洲出生的黑人在更晚期开始接受护理。结果强调了需要采取健康干预措施，促进黑人非洲移民进行 HIV 检测，并减少 HIV 检测的障碍。
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