Poor sanitary conditions are known to increase the risk of contracting amebiasis E. histolytica. In the United States, there is a much higher rate of amebiasis-related mortality in California and Texas (this might be caused by the proximity of those states to E. histolytica-endemic areas, such as Mexico), parts of Latin America, and Asia. E. histolytica is also recognized as an emerging sexually transmissible pathogen, especially in male homosexual relations, causing outbreaks in non-endemic regions. As such, high-risk sex behaviour is also a potential source of infection. Although it is unclear whether there is a causal link, studies indicate a higher chance of being infected with E. histolytica if one is also infected with HIV.
