AIDS Rates
AIDS case rates take relative population size into account. Since 1995, the rate of AIDS among AI/ANs has been higher than that for whites. In 2005, the estimated rate (per 100,000) of AIDS diagnosis for AI/AN adults and adolescents was 9.3, the 3rd highest after the rates for Black adults and adolescents (68.7) and Hispanic adults and adolescents (24.0). The estimated AIDS diagnosis rate was 6.9 for White adults and adolescents and 4.3 for Asian and Pacific Islander adults and adolescents for the same period. 12 In 2005, AIDS was diagnosed for an estimated 185 AI/AN (adults, adolescents and infants) persons. 13
HIV/AIDS Rates
Using data from the national HIV/AIDS reporting system, rates were calculated for HIV/AIDS diagnoses for the 33 states and US dependent areas with confidential name-based HIV reporting. This data shows that in 2005, the rate of HIV/AIDS cases for AI/ANs was 7.4 per 100,000 persons, the third highest rate after Blacks (for whom the rate was 54.1 per 100,000) and Hispanics (for whom the rate was 18.0 per 100,000). In contrast, the estimated HIV/AIDS rates for Whites and Asian Pacific Islanders were 5.9 and 3.6 per 100,000, respectively. Twenty-nine (29%) of the HIV/AIDS cases for AI/ANs in 2005 were females. 14
Infections
American Indians/Alaska Natives (AI/ANs) and Native Hawaiians (NHs) with AIDS are likely to be younger than non-AI/AN persons with AIDS. Among AI/ANs with AIDS reported through December 2001, 24% were less than 30 years old, compared with 16% of white, 19% of black, 20% of Hispanic, and 18% of A/PI persons with AIDS.12 Among NHs reported to the state of Hawaii through December 2000, 20% were less than 30 years of age.13 In the absence of antiretroviral therapy, progression from HIV infection to AIDS takes an average of 10 years, so many of these young people were likely infected as teenagers. 14
Modes of Exposure to HIV among AI/ANs Reported with HIV/AIDS
In 2005, there were an estimated 2,055 AI/ANs living with HIV/AIDS. Male-to-male sexual contact was the primary mode of exposure for 61% of the cumulative total of male AI/ANs with HIV/AIDS, followed by injection drug use for 15% of the AI/AN total, and injection drug use in combination with male to male sexual contact composed 13% of AI/ANs living with HIV/AIDS. High risk heterosexual contact as the primary mode of exposure accounted 10% of the AI/ANs living with HIV/AIDS. 15
In contrast, over half (68%) of female AI/ANs with HIV/AIDS were exposed to HIV through heterosexual contact and 29% were exposed through injection drug use. 16
Geographic Distribution of Reported HIV/AIDS Cases
An analysis of cases reported through December 1997 showed that although 68% of AI/AN persons with AIDS lived in metropolitan areas of more than 500,000 population at the time of diagnosis, AI/ANs with AIDS were more likely to be residents of rural areas than non-AI/AN persons with AIDS. 17 This data suggests that HIV/AIDS is both an urban and a rural (reservation) problem.
And as with the AI/AN population overall, AIDS among AI/ANs is unevenly distributed geographically. According to numbers of reported AIDS cases, the top five states are California, Oklahoma, Arizona, Washington, and New Mexico. These five states account for more than half (53%) of AI/AN AIDS cases 18 and account for 46% of the AI/AN population.19
12 Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report, 2005 (Vol. 17). Rev ed. Atlanta: U.S. Department of Health and Human Services, CDC; 2007.
13 Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report, 2005 (Vol. 17). Rev ed. Atlanta: U.S. Department of Health and Human Services, CDC; 2007.
14 Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report, 2005 (Vol. 17). Rev ed. Atlanta: U.S. Department of Health and Human Services, CDC; 2007.
15 Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report, 2005 (Vol. 17). Rev ed. Atlanta: U.S. Department of Health and Human Services, CDC; 2007.
16 Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report, 2005 (Vol. 17). Rev ed. Atlanta: U.S. Department of Health and Human Services, CDC; 2007.
17 Centers for Disease Control and Prevention. HIV/AIDS among American Indians and Alaska Natives—United States, 1981-1987. Morbidity and Mortality Weekly Report. 1998;47(8):154-60.
18 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 Health. 2005 Feb;10 (1):57-71.
19 Ogunwole S. The American Indian and Alaska Native Population: 2000. Census 2000 Brief. U.S. Census Bureau; 2002.
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