Background:
West Indian (WI) immigrants from the English-speaking Caribbean basin countries comprise almost one-third of New York City's (NYC) Black population of 2.2 million. Although the majority live in NYC neighborhoods in which the prevalence of HIV and other sexually transmitted infections (STIs) is disproportionately high, little is known about the context of HIV/STI risk among WI immigrants.



Objective:
To determine if there are differences between at risk WI-born and US-born Black men and women in sexual and drug-use risk behaviors and attitudes.

Method:
Participants were recruited from two STI treatment centers in Brooklyn, NY. They were sexually active in the past 2 months, aged 18 years or older, and diagnosed by a provider as having probable C trachomatis or N gonorrhoeae genital infection. Trained research staff interviewed participants. These analyses include data from 300 US-born (200 men, 100 women) and 287 WI-born (151 men, 136 women) Blacks.

Result:
Among both men and women, WI immigrants were less likely to report casual or one-time partners than US-born Blacks. WI-born men were less likely to have used drugs other than marijuana (p<.001). For both men and women, there were no differences between the two groups in reported condom use. However, WI-born women had less positive attitudes about using condoms with regular partners in the next 90-days (p=.06) and were less confident they could convince a regular partner to use condoms (p=.07).

Conclusion:
Although it is not possible to generalize to the larger population, WI immigrants in these clinics had fewer partners than US-born Blacks and may therefore be at lower HIV/STI risk. However, WI women's lower confidence to convince their regular partners to use condoms can potentially increase risk.

Implications:
To better understand the HIV/STI risk contexts of immigrants, place-of-birth data should be collected and assessed in any detailed survey of Black populations.