American Indians and Alaska Natives

Quick Facts

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 2007

 

 

HIV/AIDS

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.

More Information:

- HIV/AIDS Topic Site
- HIV/AIDS Surveillance Report, 2007
- HIV/AIDS Supplemental Report

Sexually Transmitted Diseases (STD)

Gonorrhea

The prevalence rate of reported gonorrhea in the United States was 111.6 cases per 100,000 population in 2008. Among AI/AN, the rate was 110.3 cases per 100,000 population.  This rate is 3.6 times higher than the 2008 rate among whites (31.0 cases per 100,000 population).   

In 2007, the rate for gonorrhea among AI/AN men and women was 69.5 and 143.4, respectively, per 100, 000 population, higher than whites (26.6 and 42.6), Hispanics (64.3 and 74.5) and Asian/Pacific Islanders (17.9 and 19.7).

Chlamydia

In 2008, the Chlamydia prevalence rate increased among all racial and ethnic groups except AI/AN. The prevalence rate among American Indians/Alaska Natives (808.8 cases per 100,000 population) was 4.7 times higher than that of whites.
However, in 2007 the Chlamydia rate for AI/AN women and men was 1158.2  and 293.8, respectively, per 100,000 population.  Only the rate among African American women (1906.0) and men (841.3) was higher.

According to the screening in Indian Health Service (IHS) clinics among young women ages 15-24 years, Chlamydia positivity was highest in region VIII, which includes  Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming.

Syphilis

From 2006 to 2007, the prevalence rate of primary & secondary syphilis increased in all racial and ethnic groups except Asian/Pacific Islanders. The prevalence rate increased 6% among AI/AN (3.2 to 3.4 cases per 100,000 population).

In 2007, the syphilis rate among AI/AN women was 2.6 per 100, 000 population, higher than among white, Hispanic and Asian/Pacific Island women.  Only the rate for black women was higher (5.6).

Trends in syphilis among young AI/AN women ages 15-19 years fluctuated from 1998 to 2005, and spiked from about 2 per 100,000 in 2006 to about 6 per 100,000 in 2007, followed by a decline to about 3 per 100,000 in 2008.

More Information:

- STD Topic Site
- STDs and Health Disparities
- STD Surveillance Report, 2008
- Chlamydia Positivity Data

Viral Hepatitis

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.

More Information:

- Viral Hepatitis Topic Site  
- Surveillance for Acute Viral Hepatitis --- United States, 2007

Tuberculosis (TB)

From 1993 to 2008, the rate of TB among AI/AN declined from 13.9 to 6.0 per 100,000 population.  TB among AI/AN is higher compared with the rate among whites (1.1).   

More Information:

- Tuberculosis Topic Site
- TB Surveillance Report, 2008

Resources

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

Dyck RF, Klomp H, Marciniuk DD, et al. The relationship between diabetes and tuberculosis in Saskatchewan: Comparison of registered Indians and other Saskatchewan people. Canadian Journal of Public Health. 2007;98(1):55-9.