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HIV & Native Americans

       Approximately 3,500 American Indians and Alaska Natives have been diagnosed with AIDS; more than 1,790 already have died.1

       The rate of AIDS diagnosis for American Indians and Alaska Natives is higher than that for whites, 14.6 cases versus 11.5 cases per 100,000 in 2006.2

       Male-to-male sexual contact, with and without concomitant injection drug use, accounted for more than three-fourths of the AIDS cases among male American Indians and Alaska Natives in 2007.3

       Stigmatization of homosexuality in native communities poses a formidable challenge to HIV/AIDS prevention and treatment efforts.4


Lack of HIV Testing in Native Communities
Native people are more likely to live in rural areas where HIV testing services are limited. Stigma about HIV and fear of seeing people they know from their close communities at local health care facilities may also stop people from getting tested. 5

Sexual Risk Factors
The presence of a sexually transmitted disease can increase the chance of contracting or spreading HIV. High rates of chlamydia trachomatis infection, gonorrhea, and syphilis among American Indians and Alaska Natives suggest that the sexual behaviors that facilitate the spread of HIV are relatively common among American Indians and Alaska Natives.

Substance Use
Persons who use illicit drugs (casually or habitually) or who abuse alcohol are more likely to engage in risky behaviors, such as unprotected sex, when they are under the influence of drugs or alcohol. In 2007, 32 percent of female American Indians and Alaska Natives living with HIV/AIDS in 34 states had become infected through injection drug use, a greater percentage than any other minority gender group.

Cultural Diversity
To be effective, HIV/AIDS prevention programs must be tailored to specific audiences. The American Indian and Alaska Native population makes up 562 federally recognized tribes plus at least 50 state-recognized tribes. Because each tribe has its own culture, beliefs, and practices and these tribes may be subdivided into language groups, it can be challenging to create programs for each group. Therefore, prevention programs that can be adapted to individual tribal cultures and beliefs are critically important. Current programs emphasize traditional teachings and the importance of the community.

Socioeconomic Issues
Issues related to poverty (for example, lower levels of education and poorer access to health care) may directly or indirectly increase the risk for HIV infection. Socioeconomic factors, such as poverty, coexist with epidemiologic risk factors for HIV infection in American Indian and Alaska Native communities. Life expectancy for American Indians and Alaska Natives is shorter than that for persons of other races/ethnicities in the United States; the rates of many diseases, including diabetes, tuberculosis, and alcoholism, are higher; and access to health care is poorer.

These indicators demonstrate the vulnerability of American Indians and Alaska Natives to additional health stress, including HIV infection.

Related Links:
National Native American AIDS Prevention Center

1-4Statement by Anthony S. Fauci, NIAID, March 2010.
5Bertolli J, McNaghten AD, Campsmith M, et al. Surveillance systems monitoring HIV/AIDS and HIV risk behaviors among American Indians and Alaska Natives. AIDS Education and Prevention 2004;16:218–237.