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