Working to Address HIV/AIDS in Native American Communities

Ronald Valdiserri

Dr. Ronald Valdiserri

In her statement last week on the observance of National Native American Heritage Month, Secretary of Health and Human Services Kathleen Sebelius reiterated the Department’s commitment to ensuring the health and well being of all Americans. She highlighted examples of how the Department is working to reduce the health disparities that have burdened American Indians and Alaska Natives.

American Indian and Alaska Native Heritage MonthEven though the numbers of HIV and AIDS diagnoses among American Indians and Alaska Natives represent less than 1% of the total cases, when population size is taken into account, rates are higher than those reported for whites. According to the most recent HIV surveillance report from the Centers for Disease Control and Prevention (CDC), the estimated rate of annual diagnoses of HIV infection from 2007 through 2010 remained stable nationally, but the rate among American Indians/Alaska Natives increased during that period. In 2010, the rate of HIV diagnoses in the American Indian/Alaska Native population was 9.7 per 100,000 persons. This rate is greater than the rates reported for the white and Asian and Pacific Islander populations. In addition, while the rate of annual AIDS diagnoses decreased nationally during 2007-2010, the rate of AIDS diagnoses among American Indians/Alaska Natives increased. In 2010, the rate of AIDS diagnoses was 7.2 per 100,000 persons in the American Indian/Alaska Native population. (Additional information is available in the CDC fact sheet “HIV/AIDS among American Indians and Alaska Natives” and in the CDC’s HIV Surveillance Report, 2010.)

As we observe National Native American Heritage Month, we salute our federal and community partners working to address these HIV/AIDS trends in the American Indian and Alaska Native populations. Some highlights include:

  • With nearly $4 million awarded from the Secretary’s Minority AIDS Initiative Fund in fiscal year 2012, the Indian Health Service (IHS) is working across its programs to promote and increase HIV testing and expand the capacity of IHS health centers to diagnose and treat HIV/AIDS, including individuals co-infected with viral hepatitis. Other activities are focused on re-engaging Native persons living with HIV in HIV care as well as enhancing the continuity and quality of care to people living with HIV/AIDS who have co-occurring substance abuse service needs.
  • The HIV/AIDS Bureau (HAB) of the Health Services and Resources Administration (HRSA) is implementing a special HIV care training initiative for health care providers serving American Indian or Alaska Native populations through the existing national network of AIDS Education and Training Centers. This training activity is also supported by the Secretary’s Minority AIDS Initiative Fund.
  • Several community health centers serving Native American populations are engaged in intensive HIV/AIDS care and treatment capacity building efforts through the HRSA-funded National Center for HIV Care in Minority Communities Exit Disclaimer (NCHCMC). The NCHCMC is working with federally supported community health centers serving communities of color to reduce HIV related health disparities by expanding HIV care and treatment capacity at the community level and facilitating linkages to care. Among the Native American-serving sites participating are the Southern Indian Health Council Exit Disclaimer and the Sacramento Native American Health Center Exit Disclaimer in California, the Kyle Health Center in South Dakota, and South Dakota Urban Indian Health Exit Disclaimer.

Those of us working to address the HIV/AIDS epidemic in the U.S. join the Secretary and our partners in Native communities across the country in celebrating National Native American Heritage Month and bolstering our commitment to ensuring that all American Indian and Alaska Native people have a healthier future, free of HIV/AIDS and other preventable diseases.


  1. While I think this article is good, I am more than a bit concerned that there was not one mention of the male-bodied Two-Spirit community….. how can there be ANY discussion about HIV/AIDS without one mention of the community that is the face and the voice of this disease? It should also be noted that this same critic holds true for the recently released IHS HIV/AIDS tribal tool kit!

    I think it is unconscionable in light of the following data showing persons living with an HIV diagnosis by the end of 2009, which includes all persons diagnosed with HIV who are alive and were diagnosed any time in the past, a higher percentage of AI/AN adults and adolescents living with HIV infection were male (73.9%), persons aged 35-44 years (33.3%) or 45-54 years (32.3%) at diagnosis, and those living at the time of diagnosis in urban areas (61.3%) or in a county with an I/T/U facility (55.5%). The majority of HIV infections among males living with HIV in 2009 were attributed to male-to-male sexual contact (64.8%).

    They are similar results for new HIV diagnoses among AI/AN. From the 2010 CDC Surveillance Report from Table 3a, 72.8% of AI/AN persons diagnosed in 2010 were male. Of those males, 72.6% were attributed to MSM and another 12.2% were MSM/IDU.

    As one can see, it is the Native M2M community (or what we would call the male-bodied two-spirit community) that is bearing a brunt of this disease with the top two categories (MSM and MSM & IDU) accounting for almost 80% of all new cases with in the Native male community in 2010 and PLWA in 2009 this same community (Two-Spirit male-bodied) accounts for 64.8%.

    Something MUST be done to bring this light and for the resources follow the epidemic!

  2. One other important note, there are currently 17 Two-Spirit organization in the country and most are unfunded and run by dedicated volunteers.

    If there is not the political will or commitment for services to be offered by non-Two-Spirit organizations, then resources should be directed these 17 organization. This is way past due; it is now a time to take action!

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