Journal of Immigrant Health

, Volume 4, Issue 2, pp 81–86

The Epidemiology of HIV and AIDS Among Central American, South American, and Caribbean Immigrants to Houston, Texas

  • Alain R. Bouckenooghe
  • Wayne X. Shandera


A retrospective study with respect to demographics and clinical parameters was conducted of all HIV/AIDS patients born in Central America, South America, and the Caribbean region, presenting to the Harris County Hospital District (public facilities) between 1994 and 1998. The original case definition criteria were fulfilled by 240 patients, 168 (70.0%) of whom were from Central America (including Panama), 42 (17.5%) of whom were from the Caribbean, and 30 (12.5%) of whom were from South America. The Central America group contained the highest proportion of women (37.5% compared with 20.8% among the group from the Caribbean and South America, P = 0.01, chi-square). The mean age was significantly lower among those born in Central America (32.4 vs. 38.8 for those born in the other two areas). The most commonly observed opportunistic infections were toxoplasmosis (14.8%), pneumocystosis (19.9%), and tuberculosis (12.1%). These data confirm the distinct epidemiologic parameters among Central American residents compared to the non-Central American populations as the Central American patients present with HIV infection to our health care system at a younger age and are more often women. The high rate of toxoplasmosis, pneumocystosis, and tuberculosis among those immigrants from the areas assessed in this study are a reminder of the need for intensified prophylaxis against these infections when working with patients from these populations.

HIV AIDS immigrants epidemiology 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Yakrus MA, Good RC: Geographic distribution, frequency, and specimen source of Mycobacterium avium complex serotypes isolated from patients with AIDS. J Clin Microbiol 1990; 28:926–929Google Scholar
  2. 2.
    Smulian AG, Sullivan DW, Linke MJ, Halsey NA, Quinn TC, MacPhail AP, Hernandez-Avila MA, Hong ST, Waltzer PD: Geographic variation in the humoral response to Pneumocystis carinii. J Infect Dis 1993; 167:1243–1247Google Scholar
  3. 3.
    Tsang PC, Samaranayake LP, Philipsen HP, McCulloug M, Reichart PA, Schmidt-Westhausen A, Scully C, Porter SR: Biotypes of oral Candida albicans isolates in HIV-infected patients from diverse geographic locations. J Oral Pathol Med 1995; 24:32–36Google Scholar
  4. 4.
    Murillo J, Castro K: HIV infection and AIDS in Latin America: Epidemiologic feature and clinical manifestations. Infect Dis Clin North Am 1994; 8:1–11Google Scholar
  5. 5.
    Cahn P, Belloso WH, Murillo J, Prada-Trujillo G: AIDS in Latin America. Infect Dis Clin North Am 2000; 14(1):185–209Google Scholar
  6. 6.
    Daar ES, Meyer RD: Medical management of AIDS patients. Bacterial and fungal infections. Med Clin North Am 1992; 76:173–203Google Scholar
  7. 7.
    United States Public Health Services/Infectious Disease Society of America (USPHS/IDSA): 1997 USPHS/IDSA guidelines for the prevention of opportunistic infections in persons infected with HIV: Disease-specific recommendations. Clin Infect Dis 1997; 25(Suppl 3):S313–S335Google Scholar
  8. 8.
    Minamoto GY, Rosenberg AS: Fungal infections in patients with AIDS. Med Clin North Am 1997; 81:381–409Google Scholar
  9. 9.
    Pappas PG, Pottage JC, Powderly WG, Fraser VJ, Stratton CW, McKenzie S, Tappper ML, Chmel H, Bonebrake FC, Blum R: Blastomycosis in patients with the acquired immunodeficiency syndrome. Ann Intern Med 1992; 116:847–853Google Scholar
  10. 10.
    Bonner JR, Alexander WJ, Dismukes WE, App W, Griffin FM, Little R, Shin MS: Disseminated histoplasmosis in patients with acquired immunodeficiency syndrome. Arch Intern Med 1984; 144:2178–2181Google Scholar
  11. 11.
    Burwen DR, Bloch AB, Griffin LD: National trends in the concurrence of tuberculosis and AIDS. Arch Intern Med 1995; 155:1281–1286Google Scholar
  12. 12.
    Montessori V, Phillips P, Montaner J, Haley L, Craib K, Bessuille E, Black W: Species distribution in HIV-related mycobacterial infections: Implications for selection of initial treatment. Clin Infect Dis 1996; 22:989–992Google Scholar
  13. 13.
    Lundgren JD, Barton SE, Lazzarin A, Danner S, Goebel FD, Pehrson P, Mulcahy F, Kosmidis J, Pederson C, Phillips AN: Factors associated with the development of Pneumocystis carinii pneumonia in 5,025 European patients with AIDS. AIDS in Europe Study Group. Clin Infect Dis 1995; 21:106–113Google Scholar
  14. 14.
    Jones JL, Hanson DL, Chu SY, Ciesielski CA, Kaplan JE, Ward JW, Navin TR: Toxoplasmic encephalitis in HIVinfected persons: Risk factors and trends. The Adult/Adolescent Spectrum of Disease Group. AIDS 1996; 10:1393–1399Google Scholar
  15. 15.
    Bourgoignie JJ: AIDS-related renal disease. Klin Wochenschr 1989; 67:889–894Google Scholar
  16. 16.
    Marras D, Bruggeman L, Tanji N, et al.: Segregated evolution of HIV-1 in renal epithelial cells from patients with HIV associated nephropathy (HIVAN): In: Abstract LB3, 8th Conference on Retroviruses and Opportunistic Infections, Chicago, IL, February 8, 2001Google Scholar
  17. 17.
    Dromer F, Mathoulin S, Dupont B, Letenneur L, Ronin O: Individual and environmental factors associated with infection due to Cryptococcus neoformans serotype D. French Cryptococcosis Study Group. Clin Infect Dis 1996; 23:91–96Google Scholar
  18. 18.
    Serrano MT, Smith NH, Shandera WX: Epidemiology of Human Immunodeficiency Virus infection in Central Americans treated in Harris County, Texas Hospital district Facilities. Am J Trop Med Hyg 1997; 57(6):678–678Google Scholar
  19. 19.
    Diaz T, Buehler JW, Castro KG, Ward JW: AIDStrends among Hispanics in the United States. Am J Public Health 1993; 83(4):504–509Google Scholar
  20. 20.
    Chimelli L, Rosemberg S, Hahn MD, Lopes MB, Netto MB: Pathology of the central nervous system in patients infected with the HIV: A report of 252 autopsy cases from Brazil. Neuropathol Appl Neurobiol 1992; 18:478–488Google Scholar
  21. 21.
    Mohar A, Romo J, Salido F, Jessurun J, Ponce de Leon S, Reyes E, Volkow P, Larraza O, Peredo MA, Cano C: The spectrum of clinical and pathological manifestations of AIDS in a consecutive series of autopsied patients in Mexico. AIDS 1992; 6:467–473Google Scholar
  22. 22.
    Drut R, Anderson V, Greco MA: Opportunistic infections in pediatric HIV infection: A study of 74 autopsy cases from Latin America. Pediatr Pathol Lab Med 1997; 17:569–576Google Scholar
  23. 23.
    Joint United Nations Programme on HIV/AIDS data, country specific, available through the internet at http://www.unaids.orgGoogle Scholar
  24. 24.
    United States Bureau of the Census: HIV/AIDS surveillance database, produced by Population Division, International Programs Center, and available through CD-ROM at ipc-hiv@census-govGoogle Scholar
  25. 25.
    Centers for Disease Control and Prevention updated data available through the internet at Scholar
  26. 26.
    Eichenberger RK, Shandera WX: The public health care of Central Americans in Houston. Tex Med 1999; 95(6):55–62Google Scholar

Copyright information

© Plenum Publishing Corporation 2002

Authors and Affiliations

  • Alain R. Bouckenooghe
    • 1
    • 2
  • Wayne X. Shandera
    • 1
  1. 1.Veterans Affairs Medical CenterHouston
  2. 2.Baylor College of MedicineHouston

Personalised recommendations