HIV/AIDS is a growing problem for American Indian communities. When population size is taken into account, American Indian/Alaskan Natives (AI/AN) rank third in the US in rates of HIV/AIDS cases, compared to all other races and ethnicities.(1) AIDS is the ninth leading killer of American Indians ages 15 to 44. Among AI/AN males, the HIV/AIDS case rate increased 2.4% from 2001 to 2004, the most significant increase observed among any reported racial/ethnic group. Among females, the rate increased 4.8%, an increase that was second only behind Asian/Pacific Islanders.(2) But, according to the CDC, these numbers may not give the whole story of the impact of the disease on American Indians. Some states with large populations of American Indians only began conducting HIV/AIDS surveillance recently. In addition, American Indian people are too often racially misclassified.(3) In Los Angeles, California alone, 56% of American Indians and Alaska Natives with AIDS were racially misclassified. These issues contribute to the difficulty of finding an accurate picture of HIV/AIDS in American Indian communities.
Within the American Indian community, there is much cultural diversity. There are 562 federally recognized Indian tribes and at least 50 tribes recognized on the state level. More than half of AI live in urban areas.(4) The most effective prevention interventions are those that are specific to different tribal beliefs and cultures. We are committed to providing culturally sensitive care and prevention services to the American Indian population. The HIV Prevention Project has created curriculum and interventions tailored specifically for Chicago’s American Indian community. AIHSC staff also reaches out to other organizations and social service agencies to ensure that their programs incorporate the needs of AI people. We engage the entire community in discussions of prevention and care, because the whole community must respond to the epidemic.
Leading Modes of Transmission
Like many other groups, for AI men, the leading mode of HIV transmission is male to male sexual contact. The second leading mode is injection drug use. For AI women, the leading mode of HIV transmission is high risk heterosexual contact, followed by injection drug use.(5)
Social and Health Disparities
American Indian communities are impacted by other social and health disparities that are associated with increased HIV risk. This includes poverty, drug and alcohol abuse, sexually transmitted infections, historical trauma, and domestic violence.(6) In 2005, it was reported that illicit drug use among American Indians/Alaskan Natives was 12.8% higher than all other races or ethnicities.(7)
In its educational program and individual prevention counseling, AIHSC confronts these issues and engages community members in discussing ways to address these problems.
Discussing Tough Topics
NatHIVe American Awareness also aims to discuss stigmas and taboos associated with homosexuality, drug and alcohol use, and condom use. While speaking about these issues may be difficult for many groups and can provoke strong emotions, open communication is necessary to addressing health needs of our community.
According to the CDC, AI may be less likely to seek HIV testing and HIV/AIDS services because of concerns about confidentiality. During 1997–2000, 50.5% of American Indians and Alaska Natives who responded to the Behavioral Risk Factor Surveillance System survey reported that they had never been tested for HIV.(8) AIHSC recognizes that concerns about confidentiality may be an issue for some of our clients. We respect the privacy of all of our clients and go to extra links to make sure clients feel comfortable in our clinic. For information on our HIPAA policy, click here.
For more information about HIV prevention issues in American Indian communities, contact us at (773) 883-9100.
1. Centers for Disease Control and Prevention
2. Northwest Portland Area Indian Health Boards, Project Red Talon
4. University of California at San Francisco, Center of AIDS Prevention Studies
6. National Native American AIDS Prevention Center & Rural Center for AIDS/STD Prevention: HIV/AIDS Prevention Guidelines for Native Americans