Ms. Shay Welch emphasized the critical need for federal agencies to gather HIV data in Indian Country. Existing systems do not collect or report HIV data in Indian Country despite the disproportionate and alarming rate of HIV infection. Education and other HIV activities targeted to Indian Country are limited. Tribes have government-to-government relationships and are not captured in federal data sets. American Indians are frequently misclassified in reporting systems. The HIV epidemic is causing a reduction in the overall Indian population.

Ms. Welch urged CHAC, HHS, CDC, HRSA and the Indian Health Service to serve as voices for indigenous people and consult with Indian Country. For example, CHAC and the federal agencies could convene a workgroup of American Indians to obtain feedback on effective and culturally-appropriate HIV prevention, care and treatment strategies for tribes.