The most recent studies of HIV among Native Americans living on the Navajo reservation in New Mexico found alarming numbers, with infections up 20 percent from 2011 to 2012. The results, reported in The New York Times, included another disturbing but little-discussed statistic: Native Americans with HIV and AIDS have lower survival rates than any other racial group.
Statistics covering 1998 to 2005 indicate HIV rates among Native Americans were slightly higher than but comparable to those of Caucasians, but lower than those of African-Americans and Latinos. The problem is that testing, treatment, and care are not reaching Native Americans the same way they’re reaching other Americans.
There are a variety of reasons for that, says Lisa Neel, program analyst at the HIV Program for the Indian Health Service, the federal government health program for American Indians and Alaska Natives. Poverty, which limits access to doctors and can put health concerns on the back burner for those struggling to feed themselves, is an all too common problem for Native Americans.
Neel says that compared with other racial and ethnic groups, American Indians and Alaska Natives have higher poverty rates, have completed fewer years of education, are younger, are less likely to be employed, and have lower rates of health insurance coverage.
This often translates into people not getting tested and, in effect, many being unaware they’re HIV-positive. At the end of 2009, 18 percent of all Americans with HIV were unaware of their infection, while 25 percent of American Indians and Alaska Natives with HIV did not know they had the disease. It’s likely that some HIV-positive people in these groups are not getting on treatment until their HIV progresses to the point that they experience symptoms.
Cultural stigma faced by some gay and bisexual Native American men could also be discouraging testing and treatment, Neel worries. She also points to higher rates of alcohol and drug use among all American Indians and Alaska Natives.
“Although alcohol and substance abuse does not cause HIV infection,” Neel says, “it is an associated risk factor because of its ability to reduce inhibitions and impair judgment. Compared with other racial/ethnic groups, AI/AN tend to use alcohol and drugs at a younger age, use them more often, and in higher quantities, and experience more negative consequences from them.”