Strengthening Knowledge

HIV/AIDS among Native Americans/Alaska Natives in the United States

According to the Center for Disease Control (CDC), American Indians/Alaska Natives (AI/AN) represent about 1.2% of the general population within the United States and 1% of HIV diagnoses nationally in 2015. However, American Indians/Alaska Natives ranked 5th in the rates of HIV diagnosis with rates lower than Blacks/African Americans, Latinos/Hispanics, Native Hawaiians/Other Pacific Islanders, and individuals reporting multiple ethnicities/races. Rates of HIV diagnoses among American Indians/Alaska Natives were also higher than Asian/Asian Americans and Whites. Within the American Indian/Alaska Native HIV diagnosis in 2015, 73% were of men and 26% were of women. Within the HIV diagnoses of American Indian/Alaska Native men, 79% were of gay and bisexual men. Most of the HIV transmission occuring in American Indian/Alaska Native women were from heterosexual contact. Over a decade from 2005 to 2014, the annual number of HIV diagnoses increased 19% among American Indians/Alaska Natives and 63% among American Indian/Alaska Native gay and bisexual men. 96 American Indians/Alaskas were diagnosed with AIDS in 2015, 59% being men and 41% being women.

Source: https://www.cdc.gov/hiv/group/racialethnic/aian/

HIV/AIDS among Native Americans/Alaska Natives in Los Angeles County

In Los Angeles County, home to the largest urban Native population in the United States, male-to-male sexual contact represents 71% of cumulative adult/adolescent AIDS cases for Native men. According to the 2009 Epidemiologic Profile of HIV/AIDS in Los Angeles County, “5.6 out of every 1,000 Native American/Alaska Natives are living with HIV/AIDS, second only to African Americans; 77% of Native American/Alaska Natives cases were among men, 23% among individuals who shared injection paraphernalia and 20% among women.”

The report goes on to state that “Native Americans/Alaska Native Transgender individuals represent 2.9% of HIV/AIDS cases which are higher in population compared to 1% of all HIV/AIDS cases in Los Angeles County.” The proportion of female American Indian/Alaskan Natives living with AIDS has also shown a high 36% increase.  Actual HIV/AIDS statistical numbers may be higher because of significant racial misclassification in HIV/AIDS  to other racial identities in reporting.

Most often, high risk sexual behaviors can be associated to historical trauma issues such as substance use, mental health, gender/sexual identity, etc. Historical trauma is the cumulative psychological and emotional wounding in a lifespan and across generations that result from a massive group trauma experience.

Native experience often reflects a loss of culture, loss of language, forced relocation, religious intolerance, poor socioeconomic conditions of reservations and a history of ethnic cleansing. Historical loss, for example, is part of the cognitive world of contemporary Natives and this sense of loss is prevalent. Depression and self-destructive behaviors are often reactions to historical trauma.

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