P2-S9.10 HIV testing behaviours among undocumented Central American immigrant women in Houston, Texas, 2010
Year: 2011
Type: article
Study design: Observational Study
Abstract: Introduction Undocumented Central American immigrants in the US are at increased vulnerability to HIV. Almost half of infections are attributed to high-risk heterosexual contact and HIV detection is often delayed. Although HIV testing is a cornerstone of HIV prevention and treatment, we are unaware of any studies that describe HIV testing in this population. The purpose of this paper is to describe HIV testing behaviours among undocumented Central American immigrant women in Houston, Texas. Methods We recruited 230 Guatemalan, Honduran, and El Salvadoran women, ages 18–50 years, living in Houston without a US visa or residency papers for an HIV behavioural survey using respondent driven sampling. Present analyses are limited to sexually active participants who provided information on HIV testing (N=182). Ever testing for HIV was defined as receiving an HIV test at least once during one's lifetime. Prevalence estimates are RDS-adjusted. Results Sixty seven per cent of women reported ever testing for HIV infection. Among testers, 49% tested at a public health clinic and 30% tested at other healthcare facilities; 50% tested within the past 2 years. The most common reason for getting tested was pregnancy (50%) and to get rid of doubt” regarding their partner's infidelity (29%). Testers were significantly more likely than non-testers to be from Honduras and to have resided in the US for over 5 years. Testers were also older, more educated, and wealthier than non-testers. Testers were more likely than non-testers to have a regular healthcare provider, to have visited a healthcare provider in the past 12 months, and to have healthcare coverage or insurance. Healthcare coverage was predominantly through the indigent healthcare program see Abstract P2-S9.10 Table 1. Abstract P2-S9.10 Table 1 Difference in socio-demographic and healthcare access and utilisation characteristics, comparing those who self-report ever testing for HIV infection to those not testing* among undoucumented Central American immigrant women in Houston, Texas, 2010 Variables Testers (%) Non-testers (%) OR (95% CI) Socio-demographics Country of origin Guatemala 20.9 40.6 1.00 Honduras 40.8 22.4 3.4 (1.42 to 8.38) El Salvador 38.3 37.0 1.96 (0.88 to 4.41) Number of years in USA Five or less 39.9 68.5 1.00 Over five 60.1 31.5 3.21 (1.62 to 6.42) Age (years) 18–30 38.2 60.8 1.00 31–50 61.8 39.2 2.59 (1.32 to 5.11) Education Sixth grade or less 42.5 73.1 1.00 Over sixth grade 57.5 26.9 3.55 (1.75 to 7.33) Employment status Unemployed 46.7 54.0 1.00 Homemaker 29.1 22.5 1.47 (0.65 to 3.41) Employed 24.2 23.5 1.14 (0.50 to 2.64) Monthly household income $800 or less 28.1 54.6 1.00 Over $800 71.9 45.4 3.14 (1.58 to 6.25) Healthcare access and utilisation Has a healthcare provider No 38.6 70.7 1.00 Yes 61.4 29.3 2.62 (1.33 to 5.22) Saw healthcare provider, past 12 months No 39.0 67.0 1.00 Yes 61.0 33.0 3.29 (1.67 to 6.55) Has health insurance or coverage No 51.4 83.8 1.00 Yes 48.6 16.2 4.86 (2.17 to 11.67) * Prevalence estimates are RDS-adjusted to account for difference in participants’ social network size and recruitment patterns. Discussion The prevalence of ever testing for HIV among undocumented Central American immigrant women in Houston was high. This seems to be due to their access to public health services through the county hospital district, which provides healthcare to all indigent residents regardless of immigration status. The association between HIV testing and regular healthcare indicates that access to public health services in this population increases the prevalence of HIV testing. Given that HIV detection among Central American immigrants is often delayed (leading to negative consequences for morbidity, mortality, and transmission), access to HIV screening is integral to HIV prevention in this population.
Source: Sexually Transmitted Infections
Authors: J Montealegre, J Risser, B J Selwyn
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2096501120