Module 3: Epidemiology of HIV/AIDS among Native Communities

Goal of Module 3:
To help you identify how and why HIV/AIDS spreads in your Native community in order to strengthen your intervention.

Epidemiology is the study of the ways in which a disease progresses through a population. In order to plan and carry out an effective intervention, you must understand how and why people in your community become infected with and spread HIV.

In this module, you will find:

  • an article on epidemiology as it relates to American Indians, Alaska Natives, and Native Hawaiians
  • Fast Facts that offer useful statistics and information
  • Fact Sheets that offer statistics for specific Native populations
  • resources for further research on the epidemiology of HIV/AIDS
  • exercises that provide steps toward learning about epidemiology in your community


Contents 1a What Is Epidemiology?

Epidemiology of HIV/AIDS among AI/AN/NHs:

2. Fast Facts about the Epidemiology of HIV/AIDS for AI/AN/NHs:
3. Fact Sheets

HIV/AIDS among AI/ANs in Alaska


HIV/AIDS among AI/ANs in Arizona


HIV/AIDS among Native Americans in California


HIV/AIDS among Native Americans in Minnesota


HIV/AIDS among AI/ANs in New Mexico


HIV/AIDS among Native Americans in New York


HIV/AIDS among Native Americans in North Carolina


HIV/AIDS among AI/ANs in Oklahoma


HIV/AIDS among Native Americans in Washington

4. Finding Data
4a. Resources
4b. Module 3 Exercises

Once there was a man who was a member of the Medicine Rite. For four years he fasted so that he might obtain greater powers. At the end of this time, he was able to obtain a song with which he could extend life-engendering greetings. The other members of the Rite gathered up for him various things by which he might become holy. These they set in front of him. Then they gathered for him plants strong in medicine, and they gathered from the blossoms that cover the body of Grandmother, those that were full of Life. They gathered for him plants of sweet fragrance and sweet taste. All these good plants of which they knew, they gave to him. Then they mixed a drink from them, a sweet tasting drink which gives Life. The song that they received is the Sweetened Drink Song which is used to give life-engendering greetings. It is this song which is used in the Medicine Rite. 9

In the story above, the Medicine Rite is born out of various ingredients; the man gathers plants full of medicine, history, fragrance, and taste to mix the drink that gives life. Likewise your HIV/AIDS prevention intervention should draw from a variety of research and information. Epidemiology—the study of the ways in which a disease progresses through a population—includes several methods of collecting the information that you need to build a successful HIV/AIDS prevention intervention. Think of statistics as one ingredient of your program.

Epidemiology Defined

Epidemiology is the study of how and why a disease spreads among a specific population. It is often called the science of public health. Epidemiological information can be used (1) to plan and evaluate strategies to prevent illness in the future, and (2) to treat patients that are already infected with the disease being studied. There are special ways to collect and interpret epidemiological data. 10

distribution – in epidemiology, the frequency and pattern of health-related characteristics and events in a population
cumulative - made up of accumulating parts; increasing by successive additions
average - the result obtained by adding several amounts together and then dividing the total by the number of amounts
mean - also known as “average,” the result obtained by adding several amounts together and then dividing the total by the number of amounts
mode of transmission - the way that the disease infects and spreads from one person to another
estimate - an approximate calculation of quantity
demographics - the statistical characteristics of human populations (such as age, race, sex, income, education, and occupation)

determinants – causes or factors associated with increased risk or probability of the disease
control – a standard of comparison; a control group ensures that any changes observed in an experimental group are due solely to the drug or experimental procedure and not to any other factors
epidemic/outbreak - the occurrence of more cases of disease than would normally be expected in a specific place or group of people over a given period of time
target/focus population - the persons for whom a program or intervention is intended
prevalence - the number or proportion of cases or events or conditions in a given population
incidence - the number of new cases in a given period of time divided by the total population at risk
population at risk - a group of people engaging in behaviors or living in conditions that increase their likelihood of infection
risk factor - an aspect of personal behavior or lifestyle, an environmental exposure, or an inborn or inherited characteristic that is associated with a higher occurrence of disease or other health-related event or condition

The Centers for Disease Control and Prevention (CDC) offers an educational program called EXCITE, Excellence in Curriculum Innovation through Teaching Epidemiology and the Science of Public Health. EXCITE was developed by CDC to teach students about the causes and prevention of disease and injury while improving their research and analytic skills. The program’s website offers An Introduction to Epidemiology, which includes useful definitions, examples, and methods of collecting data.

9 Blowsnake J. The Sweetened Drink Song. In: Dieterle R, editor and compiler The Encyclopedia of Hotcǎk (Winnebago) Mythology. 2005. Available at: Accessed February 12, 2007.

10 Coggon D, Rose G, Barker DJP. What is epidemiology? In: Epidemiology for the Uninitiated. 4th ed. BMJ Publishing Group; 1997. Available at: Accessed March 1, 2007.

11 Centers for Disease Control and Prevention. An Introduction to Epidemiology. The EXCITE page. U.S. Department of Human and Health Services; National Center for Chronic Disease Prevention and Health Promotion; CDC. Available at: Accessed March 16, 2007.