Migration patterns among Floridians with AIDS, 1993-2007: implications for HIV prevention and care.

Objectives: To characterize migration patterns among people diagnosed as having and who died of acquired immunodeficiency syndrome (AIDS) from 1993 to 2007 because migrating to a new community can disrupt human immunodeficiency virus/AIDS care delivery and patients' adherence to care and affect migrants' social services and healthcare needs.

Methods: Florida AIDS surveillance data were used to describe patterns of migration among people diagnosed as having and who died of AIDS from 1993 to 2007. Individual and community characteristics were compared between residence at the time of AIDS diagnosis and residence at the time of death by type of migration.

Results: Of 31,816 people in the cohort, 2510 (7.9%) migrated to another county in Florida and 1306 (4.1%) migrated to another state. Interstate migrants were more likely to be men, 20 to 39 years old, non-Hispanic white, and born in the United States, to have had a transmission mode of injection drug use (IDU) or men who have sex with men with IDU (MSM&IDU), and to have been diagnosed before 1999. Intercounty migrants were more likely to be non-Hispanic white, younger than 60 years, have had a transmission mode of MSM, IDU, or MSM&IDU, have higher CD4 counts/percentages, and to have lived in areas with low levels of poverty or low physician density. There was a small net movement from urban to rural areas within the state.

Conclusions: A sizable percentage of people, particularly younger people and people with a transmission mode of IDU and IDU&MSM, migrated at least once between the time of their AIDS diagnosis and death. This has important implications for care and treatment, as well as efforts to prevent the disease. Further research is needed to explore barriers and facilitators to access to care upon migration and to assess the need for programs to help people transfer their human immunodeficiency virus/AIDS care, ensuring continuity of care and adherence.