Behavioral and Clinical Characteristics of American Indian/Alaska Native Adults in HIV Care - Medical Monitoring Project, United States, 2011-2015

MMWR Morb Mortal Wkly Rep. 2019 Jan 4;67(5152):1405-1409. doi: 10.15585/mmwr.mm675152a1.

Abstract

The rate of diagnosis of human immunodeficiency virus (HIV) infection among American Indians and Alaska Natives (AI/ANs) in 2016 (10.2 per 100,000 population) was the fourth highest among seven racial/ethnic groups in the United States (1); the number of diagnoses of HIV infection among AI/AN persons increased by 70%, from 143 in 2011 to 243 in 2016 (1). However, little has been published about the sociodemographic, behavioral, and clinical characteristics of AI/AN patients with HIV infection in care because small sample sizes have led to infrequent analysis of AI/AN-specific estimates (2) and because of underestimation of AI/AN race/ethnicity in surveillance and other data sources (3). CDC analyzed data from the Medical Monitoring Project (MMP), a surveillance system that collects information about the experiences and needs of persons with diagnosed HIV infection, collected during 2011-2015 among AI/AN adults receiving HIV medical care. The results indicated that 64% of AI/AN patients with HIV infection in care achieved sustained viral suppression, and 76% achieved viral suppression at their most recent viral load test within the past 12 months, which is below the national HIV prevention goal of 80%, but comparable to or better than some other racial/ethnic groups (4). Based on self-report, 51% of AI/AN patients with HIV infection had incomes at or below the U.S. Department of Health and Human Services' (HHS) annual poverty limit, 27% had symptoms of depression, 78% reported internalized HIV-related stigma, and 20% reported binge drinking in the past 30 days. To improve the health of AI/AN patients with HIV infection, it is important that health care providers, tribal organizations, and state and local health departments consider the sociodemographic and behavioral barriers to AI/AN patients with HIV infection achieving viral suppression and design care plans that seek to eliminate those barriers.

MeSH terms

  • Adolescent
  • Adult
  • Alaska Natives / psychology*
  • Alaska Natives / statistics & numerical data
  • Anti-Retroviral Agents / therapeutic use
  • Female
  • HIV Infections / ethnology*
  • HIV Infections / therapy*
  • Humans
  • Indians, North American / psychology*
  • Indians, North American / statistics & numerical data
  • Male
  • Medication Adherence / ethnology
  • Medication Adherence / statistics & numerical data
  • Middle Aged
  • Treatment Outcome
  • United States
  • Viral Load / statistics & numerical data
  • Young Adult

Substances

  • Anti-Retroviral Agents