American Indians and Alaska Natives
American Indians and Alaska Natives (AI/AN) represented:
– 1% of the U.S. Population between 2005-2007
– 1% of new HIV infections in 2006
– 1% of all TB cases reported in 2010
Based solely on case counts, the actual impact of HIV/AIDS on American Indian/Alaska Natives may not be apparent. The small number of cases compared with other racial/ethnic populations may obscure the true meaning of epidemiologic trends among Native Americans and Alaska Natives. Rates of AIDS and HIV infection per 100,000 population provide a more accurate picture of the disease’s toll on AI/AN.
In 2007, the rate of newly diagnosed HIV/AIDS cases in AI/AN was 12.8 per 100,000 population in 34 reporting states. The newly diagnosed AIDS case rate for AI/AN was 6.9 per 100,000 population (greater than whites and Asian/Pacific Islanders) in 50 states and the District of Columbia. The AIDS mortality rate is less than 1% for AI/AN. However, based on 2002 data, proportions of persons surviving 36 months after AIDS diagnosis for AI/AN is lower (0.73) compared with whites (0.84), blacks (.79), Hispanics (0.85) and Asian/Pacific Islanders (0.89).
A recent study by Satcher Johnson, et al. 2009 revealed that HIV/AIDS rate per 100,000 population among American Indian/Alaska Native youth was greater than whites and Asian/Pacific Islanders. AI/AN males showed significant increases in diagnosis rates from 2003 to 2006. In addition, the study showed the survival of youth 36 months after AIDS diagnosis was lower for AI/AN youth, compared with white youth. Though the study was based on 2006 data, this is an important finding.
In 2010, the gonorrhea rate among American Indians/Alaska Natives was 105.7 cases per 100,000 population, which was 4.6 times the rate among whites. The disparity between gonorrhea rates for American Indians/Alaska Natives and whites was larger for American Indian/Alaska Native women (5.0 times) than for American Indian/Alaska Native men (3.9 times). In 2010, the disparity in gonorrhea rates for American Indians/Alaska Natives was higher in the West and Midwest than in the Northeast or South.
In 2010, the chlamydia rate among American Indians/Alaska Natives was 592.8 cases per 100,000 population, an increase of 7.8% from the 2009 rate of 549.8 cases per 100,000. Overall, the rate of chlamydia among American Indians/Alaska Natives in the United States was more than four times the rate among whites.
During 2009–2010, the rate of primary and secondary (P&S) syphilis among American Indians/Alaska Natives increased 8.7% (from 2.3 to 2.5 cases per 100,000 population). In 2010, 0.5% of all cases reported to CDC were among American Indians/Alaska Natives. The 2010 rate of P&S syphilis for American Indians/Alaska Natives was 1.2 times the rate for whites.
Hepatitis A incidence rates have differed historically by race; the highest rate occurs among American Indian/Alaska Natives (AI/AN). However, the incidence rate among AI/AN, which was more than 60 cases per 100,000 population before 1996, has decreased dramatically. During 2001–2007, rates among AI/AN were lower than or similar to those for other races. In 2007, the rate for AI/AN was 0.5 cases per 100,000 population.
Since 2004, the incidence of hepatitis C has plateaued among all racial/ethnic populations except for AI/AN, for whom rates fluctuated. In 2007, the rate was similar across racial/ethnic populations other than AI/AN, for whom the rate was slightly higher, 0.5 cases per 100,000 population.
In 2010, 153 of the 11,182 TB cases reported to CDC were among American Indians or Alaska Natives.
Tuberculosis in indigenous peoples in the U.S., 2003-2008. Bloss E, Holtz TH, Jereb J, Redd JT, Podewils LJ, Cheek JE, McCray E. Public Health Rep. 2011 Sep-Oct;126(5):677-89. PMID: 21886328
Patients diagnosed with tuberculosis at death or who died during therapy: association with the human immunodeficiency virus. Marks SM, Magee E, Robison V. Int J Tuberc Lung Dis. 2011 Apr;15(4):465-70. PMID: 21396204
Schneider E. Tuberculosis among American Indians and Alaska Natives in the United States, 1993-2002. American Journal of Public Health. 2005;95(5):873-880