National Native HIV/AIDS Awareness Day

Native American This year, spring begins on March 20, heralding a time of beginnings and change. March 20 also marks the annual National Native HIV/AIDS Awareness Day. This is a day for everyone to learn more about HIV and how the virus has affected native communities (Native Americans, Hawaiians and Alaskans).

HIV & Native Americans
  • HIV/AIDS continues to increase among Native people. Per population, American Indians/Alaska Natives have the third highest rates of HIV/AIDS behind Blacks and Hispanics.1

  • American Indians and Alaska Natives make up 1.5% (4.1 million people) of the total US population. The rate of AIDS diagnosis for this group has been higher than that for whites since 1995.2

  • In 2005, HIV/AIDS was diagnosed for an estimated 198 American Indians and Alaska Natives.1


Lack of HIV Testing in Native Communities
Eskimo man Native people are more likely to live in rural areas where HIV testing services are limited.3 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. During 1997–2000, 50.5% of American Indians and Alaska Natives had never been tested for HIV. This percentage was higher in the southwestern United States, where 58.1% of the American Indians and Alaska Natives reported never having been tested.4


Sexual Risk Factors
The presence of a sexually transmitted disease can increase the chance of contracting or spreading HIV.7 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. According to 2005 surveillance data by race/ethnicity, the 2nd highest rates of gonorrhea and Chlamydia trachomatis infection were those for American Indians and Alaska Natives. The 3rd highest rate of syphilis was that for American Indians and Alaska Natives. 6, 7


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.8 Results of the 2005 National Survey on Drug Use and Health indicate that the rate of current illicit drug use was higher among American Indians and Alaska Natives (12.8%) than among persons of other races or ethnicities.9


Native American womanCultural 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.10 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.11 Socioeconomic factors, such as poverty, coexist with epidemiologic risk factors for HIV infection in American Indian and Alaska Native communities. During 2002–2004, approximately one quarter (24.3%) of American Indians and Alaska Natives—about twice the national average (12.4%)—were living in poverty. 12 The proportion of the American Indian and Alaska Native population with a high school diploma (66%) in 1990 was less than the national average (75%).13

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.14, 15

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

Related Links:
"Native Soul," POZ.com

Sources:
  1. CDC. HIV/AIDS Surveillance Report, 2005. Vol. 17. Atlanta: US Department of Health and Human Services, CDC: 2006:1–46.
  2. U.S. Census Bureau. The American Indian and Alaska Native population: 2000.PDF Icon Census 2000 Brief. February 2002.
  3. Bertolli 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.
  4. CDC. Surveillance for health behaviors of American Indians and Alaska Natives: findings from the Behavioral Risk Factor Surveillance System 1997–2000. MMWR 2003;52(No. SS-07):1–13.
  5. Fleming DT, Wasserheit JN. From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sexually Transmitted Infections 1999;75:3–17.
  6. CDC. Sexually Transmitted Disease Surveillance 2005. Atlanta: US Department of Health and Human Services, CDC; November 2006: Tables 10B, 20B, 32B.
  7. McNaghten AD, Neal JJ, Li J, Fleming PL. Epidemiologic profile of HIV and AIDS among American Indians/Alaska Natives in the USA through 2000. Ethnicity and Health 2005;10:55–71.
  8. Leigh B, Stall R. Substance use and risky sexual behavior for exposure to HIV: issues in methodology, interpretation, and prevention. American Psychologist 1993;48:1035–1045.
  9. Substance Abuse and Mental Health Services Administration. Results from the 2005 National Survey on Drug Use and Health: National Findings.Rockville, Md: Substance Abuse and Mental Health Services Administration; 2006. Office of Applied Studies, NSDUH Series H-30, DHHS Publication No. SMA 06-4195.
  10. US Department of the Interior, Bureau of Indian Affairs. Indian entities recognized and eligible to receive services from the United States Bureau of Indian Affairs. Federal Register 2003(December 5);68(234):68179–68184.
  11. Diaz T, Chu SY, Buehler JW, et al. Socioeconomic differences among people with AIDS: results from a multistate surveillance project. American Journal of Preventive Medicine 1994;10:217–222.
  12. DeNavas-Walt C, Proctor BD, Lee CH. Income, Poverty, and Health Insurance Coverage in the United States: 2004.PDF Icon Washington, DC: US Government Printing Office; August 2005. Current Population Reports P60-229.
  13. US Census Bureau. The American Indian, Eskimo, and Aleut population. 2001.
  14. Korenbrot CC, Ehlers S, Crouch JA. Disparities in hospitalizations of rural American Indians. Medical Care 2003;41:626–636.
  15. Zuckerman S, Haley J, Roubideaux Y, Lillie-Blanton M. Health service access, use, and insurance coverage among American Indians/Alaska Natives and whites: what role does the Indian Health Service play? American Journal of Public Health 2004;94:53–59.