Epidemiological Profile of HIV/AIDS in Minnesota
Risk Populations: African-born Persons
African-born Persons in Minnesota
African immigration to Minnesota increased markedly during the mid-1990s; there are an estimated 72,930 (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 (33 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|
|(24 additional Countries)|
HIV/AIDS Prevalence among African-born Persons
At the end of 2012, there were 1,008 African-born persons living with HIV in Minnesota. Three countries (Ethiopia, Kenya, and Liberia) account for a majority (51%) of living African-born cases in Minnesota, however there are 30 additional countries represented among the 1,008 African-born persons living with HIV infection in Minnesota. The characteristics of foreign-born persons living with HIV/AIDS in Minnesota differ from U.S.-born, especially in gender. While females account for 18% of cases among U.S.-born persons, they account for 56% 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 41 cases diagnosed in 2012. Still, African-born persons accounted for 13 percent of new HIV infections diagnosed in 2012, but account for an estimated 1 percent of the statewide population. African-born persons have the highest rate of infection of any of the other racial groups with 56.2 cases per 100,000 population.
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 79 percent of new HIV infections among African-born males between 2010 and 2012 were attributable to heterosexual sex. However heterosexual sex was not the only mode of exposure for African-born males; MSM accounted for 18% 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 96 percent of cases among African-born females during 2010-2012. 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 947 HIV positive African-born persons included in the HIV Treatment Cascade (PDF: 952KB/2 pages) analyses. African-born persons living with HIV in Minnesota have slightly lower percentages of engagement of care at every step of the HIV treatment cascade when compared to the overall cascade in Minnesota. Viral suppression among African-born persons is 56 percent compared to 61 percent 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 44 cases among African-born persons reported in 2011 that were included in the linkage to care calculation. African-born persons have a slightly lower percentage of persons liked to care than the overall cascade at 77 percent.
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.