The epidemiology of HIV and AIDS among Central American, South American, and Caribbean immigrants to Houston, Texas.

A retrospective study with respect to demographics and clinical parameters was conducted of all HIV/AIDS patients born in Central America, South America, and the Caribbean region, presenting to the Harris County Hospital District (public facilities) between 1994 and 1998. The original case definition criteria were fulfilled by 240 patients, 168 (70.0%) of whom were from Central America (including Panama), 42 (17.5%) of whom were from the Caribbean, and 30 (12.5%) of whom were from South America. The Central America group contained the highest proportion of women (37.5% compared with 20.8% among the group from the Caribbean and South America, P = 0.01, chi-square). The mean age was significantly lower among those born in Central America (32.4 vs. 38.8 for those born in the other two areas). The most commonly observed opportunistic infections were toxoplasmosis (14.8%), pneumocystosis (19.9%), and tuberculosis (12.1%). These data confirm the distinct epidemiologic parameters among Central American residents compared to the non-Central American populations as the Central American patients present with HIV infection to our health care system at a younger age and are more often women. The high rate of toxoplasmosis, pneumocystosis, and tuberculosis among those immigrants from the areas assessed in this study are a reminder of the need for intensified prophylaxis against these infections when working with patients from these populations.