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HIV Among Native Hawaiians and Other Pacific Islanders in the United States

Fast Facts

  • Native Hawaiians and Other Pacific Islanders (NHOPI) represented less than 1% of new HIV diagnoses in the United States in 2014.
  • From 2005 to 2014, the annual number of HIV diagnoses declined 5% overall. Among NHOPI gay and bisexual men, HIV diagnoses increased 27%.
  • Nearly one-quarter of adult and adolescent NHOPI living with HIV do not know it.

	Photo of a Hawaiian man sitting on a surfboard on a beachAlthough NHOPI account for a very small percentage of new HIV diagnoses, HIV affects NHOPI in ways that are not always apparent because of their small population sizes.

The Numbers

HIV and AIDS Diagnosesa

  • In 2014, an estimated 58 NHOPI were diagnosed with HIV, representing less than 1% of new HIV diagnoses in the United States. NHOPI make up 0.2% of the population.
  • NHOPI had the fourth-highest estimated rates of HIV diagnoses (10.6 per 100,000 people) in the United States by race/ethnicity, behind blacks/African Americans, Hispanics/Latinos,b and those of multiple races.
  • Gay and bisexual menc accounted for 78% (45) of the estimated HIV diagnoses among NHOPI in 2014.
  • Overall, the annual number of HIV diagnoses declined 5% from 2005 to 2014. Among NHOPI gay and bisexual men, HIV diagnoses increased 27%.
  • In 2014, an estimated 19 NHOPI were diagnosed with AIDS in the United States.

Estimated Diagnoses of HIV Infection among Male (top) and Female (bottom) Adult and Adolescent Native Hawaiians/Other Pacific Islanders, by Transmission Category, 2014 – United States
	5/19 NP: Alt text for graphic in HIV Among Native Hawaiians. *IDU=Injection Drug Use. **Because totals were calculated independently of the values of the subpopulation, the subpopulation values do not sum to the total. Numbers less than 12 should be interpreted with caution because they have underlying relative standard errors greater than 30% and are considered unreliable.

Source: CDC. Diagnoses of HIV infection in the United States and dependent areas, 2014. HIV Surveillance Report 2016;26

Living With HIV

  • In 2012, an estimated 1,300 NHOPI were living with HIV in the United States. Of those, 23% had not been diagnosed. By comparison, 13% of all Americans living with HIV are undiagnosed.
  • Among NHOPI who were diagnosed with HIV in 2013, 70% were linked to care within 3 months.d
  • Among NHOPI diagnosed with HIV in 2011 or earlier and alive at the end of 2012, 49% were retained in HIV care.
  • Among NHOPI who were living with HIV at year-end 2012, 47% had a suppressed viral load.e

Prevention Challenges

Some behaviors put everyone at risk for HIV, including NHOPI. These behaviors include having vaginal or anal sex without a condom or without medicines to prevent or treat HIV, or sharing injection drug equipment with someone who has HIV. Other factors particularly affect NHOPI:

  • Lack of awareness of HIV status can affect HIV rates in communities. Nearly one-quarter of adult and adolescent NHOPI living with HIV do not know it.
  • Socioeconomic factors such as 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 may affect the risk of HIV infection. NHOPI cultural customs, such as norms about 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 about NHOPI health and HIV infection and small population numbers have resulted in a lack of targeted prevention programs and behavioral interventions in this population.
  • 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 that could lead to the underestimation of HIV infection in this population.

 

	photo of native hawaiian womanWhat CDC Is Doing

CDC and its partners are pursuing a high-impact prevention approach to advance the goals of the National HIV/AIDS Strategy: Updated to 2020 and maximize the effectiveness of current HIV prevention methods.

a HIV and AIDS diagnoses refer to the estimated number of people diagnosed with HIV infection, regardless of stage of disease at diagnosis, and the estimated number of people diagnosed with AIDS, respectively, during a given time period. The terms do not indicate when they were infected.
b Hispanics/Latinos can be of any race.
c The term men who have sex with men is used in CDC surveillance systems. It indicates a behavior that transmits HIV infection, not how individuals self-identify in terms of their sexuality. This fact sheet uses the term gay and bisexual men.
d In 27 states and the District of Columbia (the areas with complete lab reporting by December 2014).
e A person with a suppressed viral load has a very low level of the virus. That person can stay     healthy and has a dramatically reduced risk of transmitting the virus to others.

Bibliography

  1. CDC. Diagnoses of HIV infection and AIDS in the United States and dependent areas, 2014. HIV Surveillance Report 2016;26. Accessed March 4, 2016.
  2. CDC. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas—2013. HIV Surveillance Supplemental Report 2016;20(2). Accessed March 4, 2016.
  3. Cook WK, Chung C, Ve’e T. Native Hawaiian and Pacific Islander Health Disparities. San Francisco, CA: Asian & Pacific Islander American Health Forum; August 2010.
  4. 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.
  5. 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.
  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.

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