3. Promoting HIV Testing in Diverse Populations
American Indian/Native Alaska Populations
American Indian/Alaska Natives make up 1.5% of the total US population and 1% of the total number of HIV cases. [Surveillance 2005, Census 2002] For the period 2006 to 2009, the estimated rate per 100,000 persons for American Indian/Alaska Natives was 8.3 and 72.7 for blacks, 38.8 for Native Hawaiian/Pacific Islanders, 27.6 for Latinos, 9.8 for whites, and 8.4 for Asian. [Prejean 2011]
Among persons who had received a diagnosis of AIDS from 2001 to 2005, survival for more than 36 months was lowest among American Indian/Alaska Natives, followed by African Americans, whites, and Latinos, respectively. [CDC Surveillance 2009] After 9 years, 67% of American Indians and Alaska Natives were alive. The survival rate was 66% of blacks, 74% of Latinos, 75% of whites, and 81% of Asian/Pacific Islanders. [CDC Surveillance 2005]
Transmission categories for American Indians/Alaska Natives in 2005 were: MSM contact, 61%; IDU, 15%; MSM plus IDU, 13%; and high-risk heterosexual contact, 10%. Women accounted for 29% of HIV/AIDS diagnoses among American Indians and Alaska Natives. [CDC Surveillance 2005] Transmission categories for women were: high-risk heterosexual contact, 68%, and IDU, 29%
Due to misclassification and underreporting, these data may not reflect a complete picture of the HIV epidemic among American Indians and Alaska Natives. [Alaska 2003, Hu 2003]
Prevention and Access to Care Issues
Surveillance data by race/ethnicity from 2010 showed that the second-highest rates of gonorrhea and Chlamydia trachomatis infection and the third-highest rate of syphilis were among American Indians and Alaska Natives. [Fleming 1999, STD 2010, McNaghten 2005]
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. [SAMHSA Results 2005]
Poverty-related issues—such as lower levels of education and poorer access to healthcare services may directly or indirectly, in combination with epidemiologic factors, increase the risk for HIV infection. [Diaz 1994] During 2002 to 2004, 24.3% of American Indians and Alaska Natives - approximately twice the national average of 12.4% - were living in poverty. [DeNavas 2005] American Indians and Alaska Natives have a higher proportion of high school dropout (13.2%) than the general US population (8.1%) (US Department of Education, National Center for Education Statistics. (2011). The Condition of Education 2011 (NCES 2011-033), Indicator 20).
