Spectral analysis of HIV seropositivity among migrant workers entering Kuwait

BACKGROUND: There is paucity of published data on human immunodeficiency virus (HIV) seroprevalence among migrant workers entering Middle-East particularly Kuwait. We took advantage of the routine screening of migrants for HIV infection, upon arrival in Kuwait from the areas with high HIV prevalence, to 1) estimate the HIV seroprevalence among migrant workers entering Kuwait and to 2) ascertain if any significant time trend or changes had occurred in HIV seroprevalence among these migrants over the study period. METHODS: The monthly aggregates of daily number of migrant workers tested and number of HIV seropositive were used to generate the monthly series of proportions of HIV seropositive (per 100,000) migrants over a period of 120 months from January 1, 1997 to December 31, 2006. We carried out spectral analysis of these time series data on monthly proportions (per 100,000) of HIV seropositive migrants. RESULTS: Overall HIV seroprevalence (per 100,000) among the migrants was 21 (494/2328582) (95% CI: 19 -23), ranging from 11 (95% CI: 8 – 16) in 2003 to 31 (95% CI: 24 -41) in 1998. There was no discernable pattern in the year-specific proportions of HIV seropositive migrants up to 2003; in subsequent years there was a slight but consistent increase in the proportions of HIV seropositive migrants. However, the Mann-Kendall test showed non-significant (P = 0.741) trend in de-seasonalized data series of proportions of HIV seropositive migrants. The spectral density had a statistically significant (P = 0.03) peak located at a frequency (radians) 2.4, which corresponds to a regular cycle of three-month duration in this study. Auto-correlation function did not show any significant seasonality (correlation coefficient at lag 12 = – 0.025, P = 0.575). CONCLUSION: During the study period, overall a low HIV seroprevalence (0.021%) was recorded. Towards the end of the study, a slight but non-significant upward trend in the proportions of HIV seropositive migrants was recorded. A significant rhythmic cycle of three-month duration was observed in the proportions of HIV seropositive migrants. The underlying factors for a consistent upward trend towards the end of study period and for a significant quarterly cycle in the proportions of HIV seropositive migrants merit further investigations.