Foreign Born Figure 2. HIV Disease Diagnoses among Foreign-Born The U.S. Census Bureau uses the term “foreign born” to Residents by Region of Origin, Illinois, 2009– refer to anyone who is not a U.S. citizen at birth (U.S. 2013 Census Bureau). The U.S. foreign-born population increased from 4.7% to 12.9% of the population from 500 1970 to 2010 (U. S. Census Bureau, 2014). In Illinois, an 457 estimated 13.8% of the population was foreign born 400 from 2009–2013 (U.S. Census Bureau).

HIV Disease Diagnoses 300 Approximately 16% of persons diagnosed with HIV from 200 2007–2010 in the United States were foreign born 157 (Prosser, Tang, & Hall, 2012). From 2009–2013, of the 100 66

Number of HIV Disease Diagnoses 46 9,002 new HIV disease diagnoses in Illinois, 1,450 23 persons had missing information on country of birth. 0 Among the 7,552 individuals with country of birth Latin America Africa Asia Europe Caribbean information, 9.6% were foreign born. Annually, foreign- born individuals accounted for 8.3–11.2% of new HIV Source: Illinois Department of Public Health, June, 2014 disease diagnoses in Illinois from 2000–2013. Sex

Among foreign-born cases from 2009–2013, the Figure 1. Foreign-Born Resident Proportion of HIV proportion of females (25.6%) was higher than among Disease Diagnoses by Year of Diagnosis, U.S.-born cases (18.3%). This likely reflects higher levels Illinois, 2000–2013 of transmission among women in the country of birth.

Foreign-born women may also be at higher risk of

14% intimate partner sexual violence, which is associated with increased risk of acquiring HIV (CDC, 2014; Vaughn, 12% 11.2% 10.9% 11.1% 9.7% 9.5% 9.6% Salas-Wright, Cooper-Sadlo, et al., 2015). 10% 8.3% 8% 8.8% 8.4% Figure 3. HIV Disease Diagnoses by Sex and Nativity, 6% Illinois, 2009–2013 4%

2% Male Female

Percent New ofHIV Disease Diagnoses 0% 100%

81.8%

2000 2009 2010 2011 2012 2013 2002 2003 2004 2005 2006 2007 2008 2001 80% 74.4%

Source: Illinois Department of Public Health, June, 2014 60%

Region of Origin 40% 25.6% The country of birth for the largest number of Illinois 18.3% 20% foreign-born cases (n=377) from 2009–2013 was

Mexico. The country with the next largest number of Percent New ofHIV Disease Diagnoses 0% Foreign Born U.S. Born cases was Nigeria (n=27). By continent/region, the highest number of foreign-born cases were from Latin America (n=457) which includes Mexico. Source: Illinois Department of Public Health, June, 2014

2014 ILLINOIS HIV/AIDS EPIDEMIOLOGY PROFILE

Transmission Risk Category Among foreign-born cases, a higher proportion compared to 74% among U.S.-born cases. A higher rate reported heterosexual contact as a risk factor for of perinatal exposure was reported among foreign-born transmission compared to U.S.-born cases (33% vs. cases (1.7% vs. 0.3%). 17%). Similarly, a lower proportion of foreign-born cases reported MSM as a transmission risk factor–57%

Figure 4. HIV Disease Diagnoses by Transmission Risk Category and Nativity, Illinois, 2009–2013

MSM+IDU Perinatal Perinatal MSM+IDU 3% Exposure Exposure IDU 0% 4% 2% 6% IDU 4% Heterosexual 17% Heterosexual 33% MSM MSM 57% 74%

U.S. Born Foreign Born

Note: 18% of U. S. born and 21% of foreign-born cases had no transmission category identified. Source: Illinois Department of Public Health, June, 2014

Age at Diagnosis Figure 5. Proportion of HIV Disease Diagnoses by Age at diagnosis of individuals diagnosed with HIV Age at Diagnosis and Nativity, Illinois, disease from 2009–2013 differed by nativity. 2009–2013 Among foreign-born cases, 2.8% were ≤13 years at diagnosis compared to 0.4% of U.S.-born cases. This Foreign Born U.S. Born

likely reflects the higher rates of perinatal >60 3.7 4.0 transmission among the population. Among foreign-born cases, a lower proportion of 50-59 8.7 11.3

individuals with HIV disease were 13–24 years at 40-49 20.0 20.2 diagnosis compared to U.S.-born cases, (11.6% vs. 34.4%). 30-39 34.8 22.7 25-29 18.2 15.9

20-24 10.8 19.5

13-19 0.8 6.3

<13 2.8 0.4

Source: Illinois Department of Public Health, June, 2014

Prevalence At the end of 2013, of the 36,064 persons living with HIV disease (PLWHA) in Illinois, 2,954 were foreign

born. There has been a sharp increase in the number of foreign-born PLWHA in Illinois since the year 2000. This increase is likely due to both improved

2014 ILLINOIS HIV/AIDS EPIDEMIOLOGY PROFILE treatment regimens, which have resulted in Figure 8. Deaths among Foreign-Born Residents increased survival, as well as increased levels of Living with HIV Disease by Year of Death, immigration. Illinois, 1982–2013

Figure 6. Foreign-Born Residents Living with HIV 120 Disease by Year, Illinois, 1982–2013 101 100 87 84 3,500 80 2,954 64 57 3,000 60 47 2,500 37 40 48 29 31

2,003 Number of Deaths 27 2,000 30 21 17 20 10 29 23 1,500 1 0

1,000 696

1982 1986 1988 1990 1992 1996 1998 2000 2002 2004 2006 2010 2012 1984 1994 2008

PersonsLiving with HIV Disease 500 158 0 Source: Illinois Department of Public Health, April, 2015

1982 1986 1988 1990 1992 1996 1998 2002 2004 2006 2008 2012 1994 2000 2010 1984 REFERENCES Source: Illinois Department of Public Health, June, 2014 Centers for Disease Control and Prevention (CDC). (2014). Intersection of Intimate Partner AIDS Diagnoses Violence and HIV in Women. Retrieved June The number of AIDS diagnoses among foreign-born 25, 2015, from PLWHA in Illinois increased in the early nineties, as http://www.cdc.gov/violenceprevention/pdf seen with the epidemic overall. The increase in AIDS /ipv/13_243567_green_aag-a.pdf diagnoses in the early 2000s likely reflects the Illinois Department of Public Health (IDPH). (April, increased number of foreign-born individuals living 2015). Illinois Enhanced HIV/AIDS Reporting in Illinois after 2000. Since 2004, AIDS cases among System. foreign-born PLWHA have declined overall. IDPH. (June, 2014). Illinois Enhanced HIV/AIDS Reporting System. Figure 7. AIDS Diagnoses among Foreign-Born Prosser, A. T., Tang, T., & Hall, H. I. (2012). HIV in Residents by Year of Diagnosis, Illinois, Persons Born Outside the United States, 1981–2013 2007-2010. JAMA, 308(6), 601-607. U. S. Census Bureau. (2014). America's Foreign Born 160 146 146 in the Last 50 Years. Retrieved May 20, 2015, 140 from 113 117 111 120 105 http://www.census.gov/library/infographics 100 91 /foreign_born.html U.S. Census Bureau. (2015). State & County 80 69 89 60 QuickFacts. Retrieved June 25, 2015, from 42 69 http://quickfacts.census.gov/qfd/states/170 40

Number of AIDS Diagnoses 00.html 20 11 2 Vaughn, M. G., Salas-Wright, C. P., Cooper-Sadlo, S.,

0 Maynard, B. R., & Larson, M. (2015). Are

1982 1984 1986 1988 1990 1992 1996 1998 2000 2002 2006 2010 2012 2004 2008 1994 Immigrants More Likely than Native-Born Americans to Perpetrate Intimate Partner Source: Illinois Department of Public Health, June, 2014 Violence? J Interpers Violence, 30(11), 1888- 1904. Mortality

Despite increasing numbers of foreign-born PLWHA in Illinois, the number of deaths in this population have declined since peaking in 1994.

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