Epidemiological Profile of HIV/AIDS in Minnesota
Risk Populations: African-born Persons
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African-born Persons in Minnesota
African immigration to Minnesota increased markedly during the mid-1990s; there are an estimated 77,557 (1) African-born persons living in Minnesota. However, many believe this to be an underestimate of the true African population in Minnesota, with some community members estimating that number at close to 100,000 (2).
The sheer diversity of cultures (34 different African countries are represented among those living with HIV/AIDS in Minnesota; many nations are home to tens of cultures within their borders), and lack of education about HIV, and language and cultural barriers all pose significant challenges for HIV prevention and care efforts.
|Countries of Origin of HIV+ African-born Persons in Minnesota|
|(25 additional Countries)|
HIV/AIDS Prevalence among African-born Persons
At the end of 2014, there were 1,109 African-born persons living with HIV in Minnesota. Three countries (Ethiopia, Liberia, and Kenya) account for a majority (51%) of African-born cases living in Minnesota. However, there are 31 additional countries represented among African-born persons living with HIV in Minnesota. The characteristics of African-born persons living with HIV/AIDS in Minnesota differ from U.S.-born, especially in gender. While females account for 17% of cases among U.S.-born persons, they account for 57% of African-born cases.
New HIV Diagnoses among African born-persons
The number of new HIV infections diagnosed among African-born persons in Minnesota increased steadily from 8 cases in 1990 to 65 cases in 2002 (data not shown). However, since 2002 those numbers have decreased with 52 cases diagnosed in 2014. Still, African-born persons accounted for 17% of new HIV infections diagnosed in 2014, but account for an estimated 1% of the statewide population. African-born persons have the highest rate of infection of any of the other racial groups with 67.0 cases per 100,000 population compared to an overall rate of 5.8 per 100,000 for the state of Minnesota.
Gender and Mode of Exposure
African-born persons have a higher proportion of HIV infections acquired through heterosexual contact than other racial/ethnic groups. It is estimated that 84% of new HIV infections among African-born males diagnosed between 2012 and 2014 were attributable to heterosexual sex. However heterosexual sex was not the only mode of exposure for African-born males; MSM accounted for 10% of new HIV infections among African-born males during this time period.
Heterosexual contact with a partner who has or is at increased risk for HIV infection is estimated to account for 98% of cases among African-born females during 2012-2014. African-born women accounted for the largest number of new infections among women during this time period.
HIV Treatment Cascade among African-born persons
There were 1,032 HIV positive African-born persons included in the HIV Treatment Cascade analyses. African-born persons living with HIV in Minnesota have lower percentages of retention in care and viral suppression when compared to the overall cascade in Minnesota. Viral suppression among African-born persons is 57% compared to 63% overall in Minnesota. Compared to other racial/ethnic groups, African-born persons have similar outcomes as other persons of color, but lower engagement in care than white non-Hispanic persons.
There were 42 cases among African-born persons reported in 2013 that were included in the linkage to care calculation. African-born persons have a similar percentage of linkage to care than the overall cascade at 87%.
The American Community Survey is conducted by the U.S. Census Bureau for the years in between the decennial census. Because there are many reasons African-born persons may not be included in the census count (e.g. difficulties with verbal or written English), even 50,000 is likely an underestimate of the actual size of the African-born population living in Minnesota. Anecdotal estimates from African community members in Minnesota are as high as 100,000.