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AMERICAN INDIANS, ALASKA NATIVES AND HIV
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To
order free copies of the 2008 Ryan White
Grantee folder and fact sheets, call 1.888.ASK.HRSA
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online.
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On
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SURVEILLANCE |
Among
AI/ANs, an estimated 155 new AIDS diagnoses
were made in 2006.4 A total of
1,651 AI/ANs were estimated to be living with
AIDS at the end of 2006.5 |
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MEN |
- For
AI/AN men living with AIDS at the end
of 2006, male-to-male sexual contact is
estimated to be the most common transmission
category (57 percent)—lower than
for White men (75 percent) and Asian/Pacific
Islander (A/PI) men (72 percent). Injection
drug use (IDU) was the transmission
category in 16 percent of cases, and male-to-male
sexual contact/IDU constituted another
18 percent. High-risk heterosexual contact
was the transmission category in 8 percent
of cases.5
- The
estimated AIDS rate for adult and adolescent
AI/AN men was 12.2 in 2006, higher than
for Whites (11.2) and A/PIs (7.5) but
much lower than for Blacks (82.9) and
Hispanics (31.3).
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WOMEN |
- At
39 percent, AI/AN women estimated to be
living with AIDS at the end of 2006 were
more likely than women in any other minority
population to have IDU as their transmission
category. High-risk heterosexual contact
was the transmission category in 58 percent
of AIDS cases among AI/AN women, compared
with 67 percent among Hispanic women,
68 percent among Black women, and 78 percent
among A/PI women.2
- In
2006, AI/AN women had nearly double the
AIDS rate of White women.
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CRITICAL
ISSUES |
AI/ANs
have disproportionately high death rates
due to suicide and unintentional accidents.2
This difference may be related to higher
rates of alcoholism, tuberculosis, diabetes,
pneumonia, and influenza.7 Drug
and alcohol abuse in combination with migration
and high poverty rates among this minority
group all provide barriers to sufficient
HIV care.
From
2004 to 2006, an average of 31.4 percent
of AI/ANs lacked health insurance, comparable
to that of Hispanics (32.7 percent) but
much lower than non-Hispanic Whites (10.7
percent).8 Approximately 1 in
4 AI/ANs lived below the poverty line in
2004.5 Both lack of health insurance
and poverty are associated with poor access
to disease prevention and health care services.
Most
Indian Health Service (IHS) providers live
near tribal lands in rural areas; however,
many AI/ANs do not live in these areas.
These AI/ANs have less accessibility to
health care facilities and health care providers.2
Frequent
migration to visit family and friends, and
participate in ceremonies and religious
events can sometimes add further complications
in consistent adherence and access to health
care. In addition, for members of the Navajo
Nation, for example, frequent migration
is very common.
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HRSA'S
RESPONSE |
The
Ryan White HIV/AIDS Program supports organizations
like the National Native American AIDS Prevention
Center. The Ryan White HIV/AIDS Program
publishes materials on cultural, spiritual,
and traditional medicine practices of AI/ANs,
including the Native American Community Consultation:
Access to HIV/AIDS Care Issues. For more information,
go to www.careacttarget.org/library/NativeAmericanReport.pdf
(PDF – 222KB).
AI/ANs
can receive Ryan White HIV/AIDS Program
services even if they are eligible for care
from other sources (e.g., through IHS, tribal,
or urban Indian health programs and services).
Information about IHS facilities’
eligibility for Ryan White HIV/AIDS Program
grants is available at http://hab.hrsa.gov/law/0701.htm.
To
respond to the need for additional minority
providers of state-of-the-art HIV/AIDS care
in underserved communities, the Ryan White
HIV/AIDS Program AIDS Education and Training
Center (AETC) program published a manual
on building understanding that leads to
cross-cultural competence. For more information,
go to www.aidsetc.org/aidsetc?page=et-04-01.
The Ryan White HIV/AIDS Program also funds
a center to expand clinical expertise in
minority communities. For more information,
go to www.nmaetc.org.
Responding
to increased need in minority communities,
the National Minority AIDS Initiative was
codified into law and is now Part F of the
Ryan White HIV/AIDS Program. To learn more,
go to www.hab.hrsa.gov/treatmentmodernization/minority.htm
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END
NOTES: |
1
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U.S.
Census Bureau. 2006 American
community survey data profile highlights.
2006. Accessed June 10, 2008. |
2
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U.S.
Department of Health and Human Services.
Office of Minority Health. American
Indian/Alaska Native profile. Available
at: www.omhrc.gov/templates/browse.aspx?lvl=2&lvlID=52.
Accessed June 11, 2008. |
3 |
U.S.
Census Bureau. The American Community—American
Indians and Alaska Natives: 2004.
May 2007. Available at: www.census.gov/prod/2007pubs/acs-07.pdf
(PDF – 3391KB). Accessed June
11, 2008. |
4
|
Centers
for Disease Control and Prevention (CDC).
HIV/AIDS Surveillance Report.
2006;18:13. Table 3. |
5
|
CDC.
HIV/AIDS Surveillance Report.
2006;18:23. Table 11. |
6 |
CDC. HIV/AIDS Surveillance Report.
2006;18:15. Table 5a. |
7 |
Ashman
JJ, Perez-Jimenes D, Marconi K. Health
and support service utilization patterns
of American Indians and Alaska natives
diagnosed with HIV/AIDS. AIDS Edu
Prev. 2004;16: 238–49. |
8 |
U.S.
Census Bureau. Income, Poverty,
and Health Insurance in the United States:
2006. Washington, DC: U.S.
Government Printing Office. 2007:22.Available
at: www.census.gov/prod/2007pubs/p60-233.pdf
(PDF – 3108KB). Accessed June
10, 2008. |
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