Increased prevalence of people living with HIV among unhoused patients in Tijuana

Abstract

Background

Health Frontiers in Tijuana, a binational collaboration between Californian and Mexican universities, cares for housing-insecure patients that suffer from inequitable access to health care in urban Tijuana. This study aimed to identify the prevalence and sociodemographic correlates of HIV testing in our catchment area, as well as the prevalence and correlates of HIV status among those tested.

Methods

Analysis was performed on electronic medical record data from clinic visits during 2022-2024. Demographics and diagnostic categories were tabulated, and logistic regression was performed to determine predictors of HIV status.

Results

2390 attendances by 1158 patients were analysed. Among 180 patients tested for HIV during this time period, 18(10%; 95% CI: 6%–15%) had a new diagnosis of HIV, which is up to 50 times greater than the national 0.19% prevalence of people living with HIV in Mexico. Women (aOR: 3.5, 95% CI: 1.8–6.7), people who use drugs (aOR: 5.2, 95% CI: 2.1–13.1), and people with another sexually transmitted infection (aOR: 3.3, 95% CI: 1.6–6.7) had significantly greater risk for HIV.

Conclusions

Our data identified a niche population in Tijuana with substantially higher risk for HIV acquisition and transmission compared to the general public. This suggests a need for greater accessibility of HIV rapid testing in this group, as well as enhanced linkage to care for HIV pre-exposure prophylaxis candidates.