Authors: Shelley Hamill, Michael Dickey

Publication Year: 2005

Last Updated: 

Journal: Journal of the Association of Nurses in AIDS Care

Keywords: Awareness; Cultural Sensitivity and Appropriateness; Health Disparities; HIV/AIDS; Misclassification of AI/AN

Short Abstract: American Indian and Alaskan Native (AI/AN) people have a unique culture that is misunderstood by many health care professionals. There are nearly 2.5 million AI/ANs living in the United States in 300 different tribal or language groups and governed by 569 different tribal governments (U.S. Census Bureau, 2002).

Abstract: American Indian and Alaskan Native (AI/AN) people have a unique culture that is misunderstood by many health care professionals. There are nearly 2.5 million AI/ANs living in the United States in 300 different tribal or language groups and governed by 569 different tribal governments (U.S. Census Bureau, 2002). The myriad of ethnicities within the population labeled AI/AN or Native American makes it difficult to identify the scope of the HIV/AIDS problem under today’s system of classification. Throughout the evolution of the health care system, AI/AN populations have experienced, as have other minorities, less than adequate attention with regard to specific and culturally appropriate treatment and prevention programs (Dickey, Tafoya, & Wirth, 2003). Perhaps nowhere is this more evident than in the area of HIV/AIDS prevention and treatment. In 2000, then-U.S. Surgeon General David Satcher issued a call for action on the HIV/AIDS crisis in AI/AN communities. He stated an urgent need among Native communities as well as federal and state organizations and community health care providers to work together in an effort to fight the HIV/AIDS epidemic and to bring awareness to community members (Satcher, 2000). According to the Centers for Disease Control and Prevention (CDC, 2002), as of December 2002, there were 2,875 AIDS cases among AI/ANs. However, although the actual number of reported HIV/AIDS cases among Native Americans is relatively low, in this small population, the number is alarming. The number of AIDS cases has doubled among this population within the last 5 years (CDC). In the period from 1996 to 2002, AIDS incidence decreased markedly among Whites, Blacks, Hispanics, and Asian/Pacific Islanders but increased among AI/ANs (CDC). During that same time period, the number of deaths from AIDS also declined among all racial groups except AI/ANs (CDC). Many health professionals estimate the number of AIDS cases among AI/ANs to be much higher than what statistics are currently reporting and that the number of HIV cases could be as much as 10-times greater (Satcher, 2002). For example, a study of drug treatment patients conducted from 1991 to 1994 in New York City showed that the number of Native Americans testing positive for HIV was comparable to that of African Americans (Walters, Simoni, & Harris, 2000). This may indicate higher rates of HIV among AI/ANs within certain geographical populations. As with other minority populations, there is still a great stigma associated with HIV/AIDS within AI/AN communities. Among AI/ANs, concerns over confidentiality are evident because of the close-knit communities in which they live and the tremendous stigma of homosexuality. Many AI/ANs are not seeking testing for HIV because of this concern. As a result, underreporting of HIV among this community remains high. In addition, many Native Americans are misclassified by health care providers as Hispanic, Caucasian, African American, or Asian. During data reporting, this misclassification skews the statistics of the AI/AN population, resulting in underreporting of HIV/AIDS cases.

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Source: http://www.asph.sc.edu/news/cultural.pdf

Type of Resource: Peer-reviewed scientific article