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Epidemiologic Notes and Reports HIV Seroprevalence in Migrant and Seasonal Farmworkers -- North Carolina, 1987

The prevalence of human immunodeficiency virus (HIV) was determined for patients attending a health clinic serving approximately 4500 migrant and seasonal farmworkers in North Carolina. From August 27 to October 27, 1987, all blood specimens routinely collected at the clinic for other purposes were tested for HIV antibody by enzyme immunoassay, with confirmation by Western blot; the specimens had no personal identifiers. They were also tested for syphilis antibody by rapid plasma reagin (RPR), with confirmation by the fluorescent treponemal antibody absorption (FTA-ABS) method.

Four hundred twenty-six blood samples were collected. Eleven (2.6%) of the 426 samples were HIV-antibody-positive (Table 1). All positive specimens were from persons 13-59 years of age. The highest age-specific prevalence (6.7%) was in the 30-39-year age group. The HIV-antibody prevalence was more than twice as high for males (3.5%) as for females (1.5%). The prevalence for black males was more than twice as high (eight (5.9%) of 135) as that for black females at the same clinic (three (2.3%) of 128). Persons positive by RPR and FTA-ABS had higher rates of HIV infection (5.6%) than did those whose syphilis serologies were negative (2.2%). Only those differences in prevalence of HIV by race were statistically significant. Reported by: AE Rodman, JE Misak, MD, CL Taylor, MD, Tri-County Community Health Center, Newton Grove; DH Jolly, MPH, JM Owen-O'Dowd, North Carolina AIDS Control Program; JC Catignani, DrPH, PJ Baker, SM Jones, North Carolina State Public Health Laboratory; RA Meriwether, MD, JN MacCormack, MD, State Epidemiologist, North Carolina Div of Health Svcs. Div of Field Svcs, Epidemiology Program Office; AIDS Program, Center for Infectious Diseases, CDC.

Editorial Note

Editorial Note: Estimates of the prevalence of HIV infection in migrant and seasonal farmworkers are limited. The transience of this population makes it difficult for health-care workers to assess the health status of these persons, who frequently may not have access to health care. This survey detected a relatively high prevalence of HIV infection among black migrant and seasonal farmworkers who were patients at one clinic in North Carolina. However, the observed rates may overestimate the prevalence of HIV in migrant and seasonal farmworkers because the 426 samples tested may not be representative of the migrant and seasonal farmworker population as a whole (i.e., some of the blood specimens may have been drawn because of HIV-related symptoms or to detect sexually transmitted diseases). The results are consistent with other published reports (1-3). Additional data are required from other migrant and seasonal farmworker populations to document the extent of HIV infection and adequately target HIV prevention programs.

Outpatient clinics provide the primary opportunity to estimate the HIV seropreva lence in migrant and seasonal farmworkers seeking health care. CDC, in collaboration with the Migrant Health Program, Bureau of Health Care Delivery and Assistance, Health Resources and Services Administration, has initiated HIV seroprevalence surveys in eight clinics serving migrant and seasonal farmworkers around the country. Results obtained from these surveys will provide a basis for targeting appropriate HIV education, testing, and counseling services for this population. Migrant and seasonal farmworkers who are at increased risk and those with other sexually transmitted diseases (especially syphilis) should be encouraged to seek counseling and testing for HIV. Other innovative outreach programs will be particularly important for this difficult-to-reach population.

References

  1. Ward JW, Kleinman SH, Douglas DK, Grindon AJ, Holmberg SD. Epidemiologic characteristics of blood donors with antibody to human immunodeficiency virus. Transfusion 1988;28:298-301.

  2. CDC. Trends in human immunodeficiency virus infection among civilian applicants for military service--United States, October 1985-December 1986. MMWR 1987;36:273-6.

  3. Selik RM, Castro KG, Pappaioanou M. Racial/ethnic differences in the risk of AIDS in the United States. Am J Public Health 1988 (in press).

  4. Castro KG, Lieb S, Jaffe HW, et al. Transmission of HIV in Belle Glade, Florida: lessons for other communities in the United States. Science 1988;239:193-7.

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