Vol.:(0123456789) 1 3 J Immigrant Minority Health DOI 10.1007/s10903-017-0655-8 ORIGINAL PAPER HIV Testing Among Foreign-Born Men and Women in the United States: Results from a Nationally Representative Cross-Sectional Survey Eduardo Valverde 1  · Elizabeth DiNenno 2  · Emeka Oraka 3  · Gregory Bautista 2  · Pollyanna Chavez 2   © Springer Science+Business Media, LLC (outside the USA) 2017 Background During 2007–2010, the foreign-born population in the United States accounted for 16% of HIV diagnosed indi- viduals [1] while representing 13% of the total population in 2010 [2]. These statistics highlight that the foreign-born population in the United States is disproportionately afected by HIV. Examining the proportions of foreign-born indi- viduals infected with HIV among certain minority groups shows the disproportionate impact of HIV among this population. The Centers for Disease Control and Preven- tion’s (CDC) National HIV Surveillance System (NHSS) has reported that among Hispanics/Latinos, foreign-born individuals accounted for 42% of all HIV diagnosed cases during 2007–2010, while foreign-born individuals born in Asian countries accounted for 64% of HIV diagnosed cases among all Asians during the same time period [1]. One of the factors that has been documented to increase the risk of HIV infection among foreign-born individuals is the process of migration [3]. Individuals migrating with few personal resources may have difculty coping with the con- tinuous stressful changes that are part of migrating to a new country, which may lead to, among other things, increased levels of unsafe sexual behaviors. For those who engage in unsafe sexual behaviors, other migration-related factors such as the dissolution of pre-migration sexual networks that may confer some protection against exposure to sexually trans- mitted diseases, and the lack of use of HIV prevention ser- vices because of economic, cultural or psychosocial barriers, can impact whether foreign-born individuals are exposed to, or diagnosed with HIV infection. Foreign-born persons difer from US-born persons in terms of risk exposure to HIV, HIV testing practices, and HIV care outcomes. Heterosexual transmission of HIV is more prevalent among foreign-born individuals compared to Abstract HIV disproportionately afects the foreign-born population in the United States. This analysis describes the prevalence of ever-testing for HIV among foreign-born indi- viduals residing in the United States. Data from a national health survey of the civilian, non-institutionalized popula- tion was used to describe prevalence of ever-testing for HIV among foreign-born individuals by birth place. Multivariate logistic-regression procedures were used to determine fac- tors associated with ever-testing for HIV among foreign- born men and women. The prevalence of ever-testing for HIV among foreign-born individuals varied by region of birth ranging from 31 to 67%. Factors related to ever-testing for HIV varied by gender. Eforts need to continue in order to improve HIV testing rates among Asian foreign-born indi- viduals, lower educated foreign-born and foreign-born gay/ bisexual men. Health care providers can play an important role by counseling new arrivals regarding the importance of testing for HIV and practicing HIV risk reduction activities. Keywords Foreign-born · HIV · Testing · United States * Eduardo Valverde evalverde@cdc.gov 1 Division of Global HIV & TB, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Mail Stop E-04, Atlanta, GA 30329, USA 2 Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 3 ICF International, Centers for Disease Control and Prevention, Atlanta, Georgia