American Indian/Alaska Native; human immunodeficiency virus; HIV/AIDS; Surveillance; Indian Health


Epidemiology | Immune System Diseases | Public Health | Virus Diseases


American Indians/Alaska Natives (AI/AN) diagnosed with HIV infection have poorer survivorship and a higher percentage of Stage 3 (AIDS] diagnoses within one year of HIV diagnosis, compared to most race/ethnicity groups. National HIV surveillance data for 2008-2011 were used to determine diagnosis rates of HIV infection, persons living with HIV, and persons with a late diagnosis (Stage 3 within three months of HIV diagnosis) by selected characteristics for AI/AN and a combined other race/ethnicity group. The highest percentages of 862 AI/AN diagnosed with HIV infection were among males (75.7%), AI/AN aged 25-34 years (32.9%), persons living in large metropolitan areas (53.4%), and those diagnosed in outpatient facilities (39.4%). Among males, the majority of infections were attributed to male-to-male sexual contact (MSM) (71.8%). The percentage of infections attributed to injection drug use (IDU) for AI/AN females (28.5%) was greater than the other race/ethnicity group (15.2%). Probability of late diagnosis among AI/AN males was associated with: age >35 years, and diagnosis in emergency room or hospital, or outpatient settings, and among AI/AN females, diagnosis in hospital or emergency room. Early detection of HIV infection along with linkage to and retention in care are important for all populations, including AI/AN. Routine HIV screening at a variety of public health and outpatient facilities, and linkage to care are important to decrease HIV transmission and improve survival.