Latino HIV, TB infection rates resist broad decline

By BRADLEY J. FIKES - bfikes@nctimes.com
February 10, 2010 1:10 pm

Latinos increasingly bear the brunt of HIV and tuberculosis infections in San Diego County, according to a new study. And the great majority of those infected with both diseases are now Latino, researchers said.

Infection rates have remained unchanged among San Diego County Latinos over the past 13 years, said the study, published in the American Journal of Public Health. But rates have fallen among blacks and non-Latino whites.

The racial and ethnic disparity means that public health programs need to be adjusted to be more effective among Latinos, said Dr. Timothy C. Rodwell of the Division of Global Public Health at UC San Diego, an author of the study.

San Diego County's proximity to Mexico could be a reason that infection rates haven't fallen, Rodwell said. Many Latinos living here were born in Mexico, and tuberculosis rates are higher in that country than in the United States.

Measured in absolute numbers and compared with the county's entire population, the incidence of TB and HIV cases is "modest," Rodwell said.

San Diego County, which has a population of more than 3 million, had a total of just 5,172 cases of TB reported in the 14-year period from 1993 through 2007. And the annual number of reported TB cases in the county has declined from 469 in 1993 to 280 in 2007.

In 1994, San Diego County Latinos, who then were 23 percent of the population, made up 44 percent of tuberculosis cases. In 2007, Latinos made up 29 percent of the population, and 52 percent of TB cases.

During that same period, the percentage of Latinos among those "coinfected" with both diseases jumped from 47 percent to 82 percent.

"Our data suggests a regional Hispanic TB-HIV coinfection incidence that is out of step with national trends, (which) have shown an 86 percent decline from 1993 through 2007," the study stated.

"Although the prevalence of TB-HIV disease in the county overall is modest, concentration of the disease in one particular segment of the population is cause for concern because that segment may become a reservoir from which infection spreads to the wider population."

Infection with one disease makes infection with the other more likely, and multiplies the harm from each.

"If you have tuberculosis but don't have HIV, there's a greater chance that you'll get HIV," Rodwell said. "If you have HIV and you don't have tuberculosis, there's a greater chance you'll get tuberculosis."

Call staff writer Bradley J. Fikes at 760-739-6641. Read his blogs at http://bizblogs.nctimes.com .

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