HIV diagnosis and utilisation of HIV-related medical care among foreign-born persons in New York City, 2001-2009

Objectives: To measure trends in HIV diagnoses among foreign-born (FB) New Yorkers and compare the epidemic in FB with that in non-FB (NFB). Methods: New York City (NYC) HIV/AIDS surveillance registry data were used to measure trends in HIV diagnoses in 2001-2009, calculate HIV diagnosis rates by area of birth, and compare demographic and care characteristics of FB and NFB diagnosed in 2006-2009. The registry contains data on all New Yorkers diagnosed with HIV infection, HIV disease and AIDS, and receives laboratory results on all New Yorkers living with HIV/AIDS. Results: From 2001 to 2009, new HIV diagnoses among FB increased modestly in number but significantly as a percent of all cases (17% in 2001 to 28% in 2009; p<0.01). In 2006-2009, the annual rate of diagnosis was lower among FB than NFB (37 vs 56 per 100 000). Compared with NFB, FB persons were significantly more likely to be diagnosed concurrently with AIDS; FB had a lower median CD4 count at initiation of care. FB persons were less likely to have insurance, and 13% needed language interpretation services. Conclusions: The percentage of HIV diagnoses in NYC attributed to FB persons has increased. HIV infection may remain undiagnosed longer in FB than NFB. FB may benefit from targeted prevention outreach and other services.