Immigration and HIV/AIDS in the New York Metropolitan Area

Abstract

Because the HIV pandemic undergoes continual change in its locations and affected populations, it is crucial to study HIV risk behaviors among mobile and immigrant groups within and across borders. The impact of cross-cultural migrations and the importance of studying that impact in terms of demographic characteristics as well as cultural and environmental factors has not received adequate attention in public health research. This collaborative analysis utilizes data from three studies of immigrant groups in New York to describe and compare these factors that provide the context for risk and prevention of HIVAIDS and other health challenges. Data discussed were obtained utilizing multi-method approaches to identify and describe HIV risks among both new and more established immigrant populations within the urban settings of North America, with NYC as a central focus. Demographic and epidemiological data situate the analysis within the larger contexts of US migration and the HIV/AIDS epidemic in NYC. The authors identify risk and protective factors embedded to varying degrees in immigrants_ multiple cultures and sub-cultures. The three populations studied include: 1) new Hispanic immigrants from the Dominican Republic, Mexico and Central America; 2) West Indian (Caribbean) immigrants from Jamaica, Trinidad/ Tobago and other anglophone Caribbean nations; and 3) South Asian immigrants from India (Indian Americans). The paper seeks differences and commonalities, focusing on the social, attitudinal and behavioral factors that contribute to increased HIV/AIDS vulnerability among these populations. The data presented also identify some of the attitudes and behaviors of individuals and groups, as well as other facilitators and obstacles to transmission for immigrants as they adapt to new environments. Topics addressed include factors affecting HIV/AIDS vulnerability of immigrant groups, goals and expectations, health and mental heath issues, gender role change, sexual risk, alcohol and other drug use, perception of HIV/AIDS risk and implications for prevention.

The five-year impact of an evolving global epidemic, changing migration patterns, and policy changes in a regional Canadian HIV population

“…Similar to trends seen in other developed countries [22][23][24][25][26][27][28][29], our immigrant/refugee population, especially those from Sub-Saharan Africa, is diagnosed at a later stage in their HIV infection, with lower CD4 counts, a larger percentage of females, different HIV subtypes, and a different array of co-morbidities previously rare for Canada, such as tuberculosis and toxoplasmosis. We found that management and monitoring of disease progression is more intense, requiring more clinic al visits and laboratory testing to anticipate the different responses to treatment by the various non-B subtypes as discussed in Spira et al [18].…”

Sexual risk behaviour among HIV-positive patients at an urban clinic in Santiago, Dominican Republic

“…The future of HIV/ AIDS in the Dominican Republic is particularly tenuous because of a multitude of factors that connect the epidemic to communities outside the country. There is a porous border the country shares with Haiti where the adult prevalence is the highest in the Western hemisphere, a large flux of immigrants to and from the United States and Caribbean neighbours, and the Dominican Republic remains a popular destination for sex tourism (Brewer et al, 1998;Forsythe et al, 1998;Shedlin et al, 2006).…”

“…To control the epidemic, it is imperative that interventions focus on safe sex practices in high-risk groups, yet little is known about sexual risk behaviours among HIV-positive patients in the Dominican Republic. There is little adult clinical behavioural research from this nation and previous studies have focused on sexual risk factors in specific sub-populations Á commercial sex workers and those who live in the bateys, sugar cane plantations home to high numbers of migrant Dominican and Haitian labourers (Brewer et al, 1998;Forsythe et al, 1998;Shedlin et al, 2006;Cohen, 2006;Kerrigan et al, 2006). Secondary prevention efforts, however, must be targeted at infected individuals across a range of communities.…”

Sexual risk behavior among HIV-positive patients at an urban clinic in Santiago, Dominican Republic

“…The future of HIV/AIDS in the Dominican Republic is particularly tenuous because of a multitude of factors that connect the epidemic to communities outside the country. There is a porous border the country shares with Haiti where the adult prevalence is the highest in the Western hemisphere, a large flux of immigrants to and from the United States and Caribbean neighbors, and the Dominican Republic remains a popular destination for sex tourism (Brewer et al, 1998;Forsythe, Hasbun, & Butler de Lister, 1998;Shedlin et al, 2006).…”

“…To control the epidemic, it is imperative that interventions focus on safe sex practices in high-risk groups, yet little is known about sexual risk behaviors among HIV-positive patients in the Dominican Republic. There is little adult clinical behavioral research from this nation and previous studies have focused on sexual risk factors in specific sub-populations Á commercial sex workers and those who live in the bateys, sugar cane plantations home to high numbers of migrant Dominican and Haitian laborers (Brewer et al, 1998;Cohen, 2006;Forsythe et al, 1998;Kerrigan et al, 2006;Shedlin et al, 2006). Secondary prevention efforts, however, must be targeted to infected individuals across a range of communities.…”