Journal of Immigrant and Minority Health

, Volume 21, Issue 1, pp 30–38 | Cite as

Differences Between U.S.-Born and Non-U.S.-Born Black Adults Reported with Diagnosed HIV Infection: United States, 2008–2014

  • Hanna B. DemekeEmail author
  • Anna S. Johnson
  • Baohua Wu
  • Ndidi Nwangwu-Ike
  • Hope King
  • Hazel D. Dean
Original Paper


Despite improvements in its treatment, HIV infection continues to affect Blacks disproportionally. Using National HIV Surveillance System data from 50 U.S. states and the District of Columbia, we examined demographic and epidemiologic differences between U.S.-born and non-U.S.-born Black adults. Of 110,452 Black adults reported with diagnosed HIV during 2008–2014 with complete country of birth information, 11.1% were non-U.S.-born. Non-U.S.-born were more likely to be older, female, have HIV infection attributed to heterosexual contact, have been diagnosed late, and live in the northeastern U.S. region. During 2014, the HIV diagnosis rate among African-born Black females was 1.4 times the rate of U.S.-born Black males, 2 times the rate of African-born Black males, and 5.3 times the rate of U.S.-born Black females. We elucidate the differences between U.S.-born and non-U.S.-born Blacks on which to base culturally appropriate HIV-prevention programs and policies.


Human immunodeficiency virus Acquired immunodeficiency syndrome African Americans Non-U.S.-born Immigrants 


  1. 1.
    Hall HI, Song R, Tang T, et al. HIV trends in the United States: diagnoses and estimated incidence. JIMR Public Health Surveill. 2017;3(1):e8.CrossRefGoogle Scholar
  2. 2.
    Frieden TR, Foti KE, Mermin J. Applying public health principles to the HIV Epidemic-How are we doing? N Engl J Med. 2015;373(23):2281–7.CrossRefGoogle Scholar
  3. 3.
    Rastogi S, Johnson TD, Hoeffel EM, Drewery MP Jr. The Black population: 2010. Washington, DC: US Census Bureau; 2011. Accessed 14 June 2017.
  4. 4.
    Johnson AS, Hu X, Dean HD. Epidemiologic differences between native-born and foreign-born black people diagnosed with HIV infection in 33 U.S. states, 2001–2007. Public Health Rep. 2010;125(Suppl 4):61–9.CrossRefGoogle Scholar
  5. 5.
    Willis LA, Opoku J, Murray A, et al. Diagnoses of human immunodeficiency virus (HIV) infection among foreign-born persons living in the District of Columbia. J Immigr Minor Health. 2015;17(1):37–46.CrossRefGoogle Scholar
  6. 6.
    Blanas DA, Nichols K, Bekele M, et al. HIV/AIDS among African-born residents in the United States. J Immigr Minor Health. 2013;15(4):718–24.CrossRefGoogle Scholar
  7. 7.
    Pivnick A, Jacobson A, Blank AE, et al. Accessing primary care: HIV+ Caribbean immigrants in the Bronx. J Immigr Minor Health. 2010;12(4):496–505.CrossRefGoogle Scholar
  8. 8.
    Myers TR, Lin X, Skarbinski J. Antiretroviral therapy and viral suppression among foreign-born HIV-Infected persons receiving medical care in the United States: a complex sample, cross-sectional survey. Medicine. 2016;95(11):e3051.CrossRefGoogle Scholar
  9. 9.
    Page LC, Goldbaum G, Kent JB, et al. Access to regular HIV care and disease progression among black African immigrants. J Natl Med Assoc. 2009;101(12):1230–6.CrossRefGoogle Scholar
  10. 10.
    Prosser AT, Tang T, Hall HI. HIV in persons born outside the United States, 2007–2010. JAMA. 2012;308(6):601–7.CrossRefGoogle Scholar
  11. 11.
    Anderson M. A rising share of the U.S. Black population is foreign born; 9 percent are immigrants; and while most are from the Caribbean, Africans drive recent growth. Washington, DC: Pew Research Center; 2015. Accessed 14 June 2017.
  12. 12.
    Grieco EM, Acosta YD, Cruz PD, et al. The foreign-born population in the United States: 2010. Washington, DC: The United States Census Bureau; 2012. Accessed 14 June 2017.
  13. 13.
    US Census Bureau. Foreign-born. Washington, DC: US Census Bureau; 2016. Accessed 14 June 2017.
  14. 14.
    United Nations Department of Economic and Social Affairs. Demographic yearbook 2014. New York: United Nations; 2015. Accessed 14 June 2017.
  15. 15.
    US Census Bureau. Geographic terms and concepts—urban and rural. Washington, DC: US Census Bureau; 2012. Accessed 14 June 2017.
  16. 16.
    U.S. Department of Commerce. Economics and Statistics Administration Bureau of the Census. Chapter 6: statistical groupings of states and counties. In: Geographic areas reference manual. Washington, DC: US Census Bureau; 1994. Accessed 14 June 2017.
  17. 17.
    US Census Bureau. American FactFinder. Washington, DC: US Census Bureau; [undated]. Accessed 14 June 2017.
  18. 18.
    Gambino CP, Trevelyan EN, Fitzwater JT. The foreign-born population from Africa: 2008–2012. Washington, DC: US Census Bureau; 2014. American Community Survey Briefs ACSBR/12-16. Accessed 14 June 2017.
  19. 19.
    Zong J, Batalova J. Caribbean immigrants in the United States. The Online Journal of the Migration Policy Institution, September 14, 2016. Accessed 14 June 2017.
  20. 20.
    Centers for Disease Control and Prevention (CDC). HIV Surveillance Report, 2015. Vol. 27. Atlanta, GA: US Department of Health and Human Services, CDC; 2016. Accessed 9 Nov 2017.
  21. 21.
    Kerani RP, Kent JB, Sides T, et al. HIV among African-born persons in the United States: a hidden epidemic? J Acquir Immune Defic Syndr. 2008;49(1):102–6.CrossRefGoogle Scholar
  22. 22.
    Ashton C, Bernhardt SA, Lowe M, et al. Comparison of HIV/AIDS rates between U.S.-born Blacks and African-born Blacks in Utah, 2000–2009. Open AIDS J. 2012;6:156–62.CrossRefGoogle Scholar
  23. 23.
    The Henry J. Kaiser Family Foundation. The global HIV/AIDS epidemic; November 2017.
  24. 24.
    Beyene Y. Potential HIV risk behaviors among Ethiopians and Eritreans in the diaspora: a bird’s- eye view. Northeast Afr Stud. 2000;7(2):119–42.CrossRefGoogle Scholar
  25. 25.
    Rosenthal L, Scott DP, Kelleta Z, et al. Assessing the HIV/AIDS health services needs of African immigrants to Houston. AIDS Educ Prev. 2003;15(6):570–80.CrossRefGoogle Scholar
  26. 26.
    Hoffman S, Beckford Jarrett ST, Kelvin EA, et al. HIV and sexually transmitted infection risk behaviors and beliefs among black West Indian immigrants and US-born blacks. Am J Public Health. 2008;98(11):2042–50.CrossRefGoogle Scholar
  27. 27.
    Ojikutu B, Nnaji C, Sithole-Berk J, et al. Barriers to HIV testing in black immigrants to the U.S. J Health Care Poor Underserved. 2014;25(3):1052–66.CrossRefGoogle Scholar
  28. 28.
    Koku EF. HIV-related stigma among African immigrants living with HIV/AIDS in USA. Sociological Research Online. 2010. Scholar
  29. 29.
    Lawson E, Gardezi F, Calzavara L, Husbands W, Myers T, Tharao WE. HIV/AIDS stigma, denial, fear and discrimination: experiences and responses of people from African and Caribbean communities in Toronto. Toronto: University of Toronto; 2006. Accessed 14 June 2017.
  30. 30.
    Wiewel EW, Torian LV, Hanna DB, et al. Foreign-born persons diagnosed with HIV: where are they from and where were they infected? AIDS Behav. 2015;19(5):890–8.CrossRefGoogle Scholar
  31. 31.
    Singh GK, Rodriguez-Lainz A, Kogan MD. Immigrant health inequalities in the United States: use of eight major national data systems. Sci World J. 2013;2013:512313.Google Scholar
  32. 32.
    Read JG, Emerson MO, Tarlov A. Implications of black immigrant health for U.S. racial disparities in health. J Immigr Health. 2005;7(3):205–12.CrossRefGoogle Scholar
  33. 33.
    Centers for Disease Control and Prevention (CDC). DHAP Strategic Plan 2017–2020. Atlanta, GA: US Department of Health and Human Services, CDC; 2011.

Copyright information

© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2018

Authors and Affiliations

  • Hanna B. Demeke
    • 1
    Email author
  • Anna S. Johnson
    • 2
  • Baohua Wu
    • 3
  • Ndidi Nwangwu-Ike
    • 3
  • Hope King
    • 4
  • Hazel D. Dean
    • 5
  1. 1.National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP)Centers for Disease Control and Prevention (CDC)AtlantaUSA
  2. 2.Division of HIV/AIDS Prevention (DHAP) at NCHHSTPCDCAtlantaUSA
  4. 4.Division of Viral HepatitisNCHHSTP, CDCAtlantaUSA
  5. 5.NCHHSTP, CDCAtlantaUSA

Personalised recommendations