“Who takes the test?”- HIV testing and sexual risk behaviors of U.S. and foreign-born adults

Background: Increasing immigration to the United States is a growing public health concern; this population mobility will accelerate the spread of HIV infection. Although HIV rates are increasing among immigrants, research on specific behavioral risk factors such as HIV testing is still lacking. This study compares HIV-testing and sexual risk behaviors of foreign-born to U.S.-born adults.

Methodology: Cross-sectional survey data from the 2008 New York City Community Health Survey of adults (n=7554) were used for this study (U.S.-born= 61% and foreign-born=39%). Bivariate analyses were conducted to compare HIV-testing and sexual risk behaviors of U.S.-born to foreign-born adults by nativity, sex, race and education.

Results: Women were more likely to receive HIV tests that men. Foreign born women were more likely to receive HIV tests than U.S. born women. Compared to foreign born adults, U.S.-born adults were twice as likely to have two or more sexual partners within the past year, less likely to have used condoms and reported higher HIV testing rates among those with less education. Black and Hispanic adults reported the highest HIV-testing rates overall. All reported outcomes were significant (p < 0.001).

Conclusion: Significant differences exist between U.S.-born and foreign-born adults for HIV-testing and sexual risk behaviors. Results are parallel with research indicating vulnerable and minority populations have higher HIV testing rates. Further examination of psycho-graphic variables contributing to risk behaviors within nativity groups is needed. Interventions should be tailored to target specific demographic and behavioral factors contributing to HIV risk.