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HIV and Native Hawaiians and Other Pacific Islanders

Although Native Hawaiians and Other Pacific Islanders (NHOPI) account for a very small percentage of new HIV diagnosesa in the United States (US) and dependent areas,b HIV affects NHOPI in ways that are not always apparent because of their small population sizes. In 2017, NHOPI made up 0.2% of the US population.c

The Numbers

HIV Diagnoses

This chart shows the number of new HIV diagnoses in the United States and dependent areas among Native Hawaiians and Other Pacific Islanders by transmission category in 2017. Of the 38,739 new HIV diagnoses in the United States and dependent areas, 58 adult and adolescent Native Hawaiians and Other Pacific Islanders (NHOPI) received an HIV diagnosis. 46 were among NHOPI men and 12 were among NHOPI women.

 

This chart shows the number of new HIV diagnoses in the United States and dependent areas among Native Hawaiians and Other Pacific Islanders by transmission category in 2017. Women, Heterosexual contact = 11; Women, Injection drug use = 1; Men, Male-to-male sexual contact = 39; Men, Heterosexual contact = 4; Men, Injection drug use = 1; Men, Male-to-male sexual contact and injection drug use = 2.

Source: CDC. Diagnoses of HIV infection in the United States and dependent areas, 2017. HIV Surveillance Report 2018;29.

From 2010 to 2016, HIV diagnoses decreased 16% among NHOPI overall in the 50 states and the District of Columbia. But trends varied by gender.

This chart shows HIV diagnoses trends for Native Hawaiians and Other Pacific Islanders from 2010 to 2016. HIV diagnoses among Native Hawaiians and Other Pacific Islanders overall decreased 16%, men decreased 20%, and women remained stable.

Source: CDC. NCHHSTP AtlasPlus. Accessed April 25, 2019.

Living With HIV

At the end of 2016, 877 adult and adolescent Native Hawaiians and Other Pacific Islanders (NHOPI) in the United States had diagnosed HIV. For every 100 NHOPI with diagnosed HIV in 2015, 70 received some HIV care, 49 were retained in care, and 61 were virally suppressed. A person with HIV who takes HIV medicine as prescribed and gets and stays virally suppressed or undetectable can stay healthy and has effectively no risk of sexually transmitting HIV to HIV-negative partners.

Source: CDC. Diagnoses of HIV infection in the United States and dependent areas, 2017. HIV Surveillance Report 2018;29.
CDC. Selected national HIV prevention and care outcomes (slides). Accessed April 25, 2019.

Deaths

In 2016, there were 14 deaths among adult and adolescent NHOPI with diagnosed HIV in the US and dependent areas. These deaths may be due to any cause.

Prevention Challenges

There are some behaviors that put everyone at risk for HIV. These behaviors include having anal or vaginal sex without protection (like a condom or medicine to prevent or treat HIV), or sharing injection drug equipment with someone who has HIV. Factors that particularly affect NHOPI include:

  • Socioeconomic factors. Poverty, inadequate or no health care coverage, language barriers, and lower educational attainment among NHOPI may contribute to lack of awareness about HIV risk and higher-risk behaviors.
  • Cultural factors. NHOPI cultural customs, such as not talking about sex across generations, may stigmatize sexuality in general, and homosexuality specifically, as well as interfere with HIV risk-reduction strategies, such as condom use.
  • Limited research. Limited research about NHOPI health and HIV infection and small population numbers have resulted in a lack of targeted prevention programs and behavioral interventions for this population.
  • Data limitations. The low reported number of HIV cases among NHOPI may not reflect the true burden of HIV in this population because of race/ethnicity misidentification. This could lead to an underestimation of HIV infection in this population.

What CDC Is Doing

CDC and its partners are pursuing a high-impact prevention approach to maximize the effectiveness of current HIV prevention interventions and strategies and improve surveillance among NHOPI. Funding state, territorial, and local health departments is CDC’s largest investment in HIV prevention.

  • Through its Let’s Stop HIV Together (formerly Act Against AIDS) campaigns and partnerships, CDC provides NHOPI with effective and culturally appropriate messages aimed at stopping HIV stigma and promoting HIV testing, prevention, and treatment. The stigma materials include stories and issues relevant to NHOPI, as do the following:
    • Doing It encourages all people to know their HIV status and protect themselves and their community by making HIV testing a part of their regular health routine.
    • Start Talking. Stop HIV. helps gay and bisexual men communicate about testing and a range of HIV prevention strategies.
    • HIV Treatment Works shows how people living with HIV have overcome barriers to stay in care and provides resources on how to live well with HIV.
    • Partnering and Communicating Together (PACT) to Act Against AIDS is raising awareness about testing, prevention, and retention in care among populations disproportionately affected by HIV, including NHOPI.

a HIV diagnoses refers to the number of people who received an HIV diagnosis during a given time period, not when the people got HIV infection.
b Unless otherwise noted, the term United States (US) includes the 50 states, the District of Columbia, and the 6 dependent areas of American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, the Republic of Palau, and the US Virgin Islands.
c The US Census Bureau’s population estimates include the 50 states, the District of Columbia, and Puerto Rico.

Bibliography

  1. CDC. Diagnoses of HIV infection in the United States and dependent areas, 2017. HIV Surveillance Report 2018;29.
  2. CDC. Estimated HIV incidence and prevalence in the United States 2010-2016. HIV Surveillance Supplemental Report 2019;24(1).
  3. CDC. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas, 2016. HIV Surveillance Supplemental Report 2018;23(4).
  4. CDC. NCHHSTP AtlasPlus. Accessed April 25, 2019.
  5. CDC. Selected national HIV prevention and care outcomes (slides).
  6. Adih WK, Campsmith M, Williams CL, Hardnett FP, Hughes D. Epidemiology of HIV among Asians and Pacific Islanders in the United States, 2001-2008. J Int Assoc Physicians AIDS Care (Chic) 2011;10(3):150-9. PubMed abstract.
  7. DiStefano AS, Hui B, Barrera-Ng A, et al. Contextualization of HIV and HPV risk and prevention among Pacific Islander young adults in Southern California. Soc Sci Med 2012;75(4):699-708. PubMed abstract.
  8. Takahashi LM, Kim AJ, Sablan-Santos L, et al. HIV testing behavior among Pacific Islanders in Southern California: Exploring the importance of race/ethnicity, knowledge, and domestic violence. AIDS Educ Prev 2011;23(1):54-64. PubMed abstract.

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