Assessing New Diagnoses of HIV Among American Indian/Alaska Natives Served by the Indian Health Service, 2005-2014

Reilley, Brigg; Haberling, Dana L.; Person, Marissa K; Leston, Jessica; Iralu, Jonathan; Haverkate, Rick; Siddiqi, Azfar-e-Alam

doi:10.1177/0033354917753118

Cited by 7 publications

(6 citation statements)

References 7 publications

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“…We categorized geographic regions as described elsewhere. 5,22 We calculated rates of each IDU indicator for 2010-2014 combined per 10 000 AI/AN adults to compare the burden between strata by using IDU indicator counts and the corresponding aggregation of NPIRS annual denominators; we used Poisson regression analysis to calculate rate ratios (RRs) and 95% confidence intervals (CIs).…”

Section: Resultsmentioning

confidence: 99%

“…We accessed data through an existing Centers for Disease Control and Prevention-IHS data-use agreement, which permits geographic analyses of data at the regional and national level only. 5,14 The Indian health system supported by IHS serves IHS (federal), tribal, and urban (I/T/U) facilities and consists of 45 hospitals and more than 300 health centers in 37 US states, mainly primary care clinics in rural areas that are either federally or tribally operated 15 and contracted out-of-network health facilities, as needed. 15 Electronic health records at I/T/U facilities and some contracted care records are collected at the national level and maintained by the IHS National Patient Information Reporting System (NPIRS) using the National Data Warehouse.…”

Section: Data Sourcementioning

confidence: 99%

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Trends in Indicators of Injection Drug Use, Indian Health Service, 2010-2014

et al. 2020

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Objectives Hepatitis C virus (HCV) and HIV transmission in the United States may increase as a result of increasing rates of opioid use disorder (OUD) and associated injection drug use (IDU). Epidemiologic trends among American Indian/Alaska Native (AI/AN) persons are not well known. Methods We analyzed 2010-2014 Indian Health Service data on health care encounters to assess regional and temporal trends in IDU indicators among adults aged ≥18 years. IDU indicators included acute or chronic HCV infection (only among adults aged 18-35 years), arm cellulitis and abscess, OUD, and opioid-related overdose. We calculated rates per 10 000 AI/AN adults for each IDU indicator overall and stratified by sex, age group, and region and evaluated rate ratios and trends by using Poisson regression analysis. Results Rates of HCV infection among adults aged 18-35 increased 9.4% per year, and rates of OUD among all adults increased 13.3% per year from 2010 to 2014. The rate of HCV infection among young women was approximately 1.3 times that among young men. Rates of opioid-related overdose among adults aged <50 years were approximately 1.4 times the rates among adults aged ≥50 years. Among young adults with HCV infection, 25.6% had concurrent OUD. Among all adults with arm cellulitis and abscess, 5.6% had concurrent OUD. Conclusions Rates of HCV infection and OUD increased significantly in the AI/AN population. Strengthened public health efforts could ensure that AI/AN communities can address increasing needs for culturally appropriate interventions, including comprehensive syringe services programs, medication-assisted treatment, and opioid-related overdose prevention and can meet the growing need for treatment of HCV infection.

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Section: Resultsmentioning

confidence: 99%

Section: Data Sourcementioning

confidence: 99%

Trends in Indicators of Injection Drug Use, Indian Health Service, 2010-2014

et al. 2020

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“…CBPR strategies are especially needed to meet the national effort to reduce new HIV infections by 90% through the Ending the Epidemic initiative [ 40 ]. Indian Health Service (IHS) provider visit data indicate that men that were aged 20 to 59 years had the highest rate of new HIV diagnoses among people receiving care through IHS [ 5 ]. In addition to addressing barriers to accessing HIV/STI-related health service, strategies to reach AI/AN at highest risk for HIV (e.g., men aged 20 to 59) are urgently needed.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, approximately 24% of AI/AN with HIV are unaware of their HIV status as compared to 16% of the general U.S. population with undiagnosed HIV [ 2 ]. AI/AN are also more likely to die from HIV when compared to other racial/ethnic groups due to later HIV diagnoses and being less likely to receive adequate care [ 4 , 5 ]. One factor contributing to AI/AN HIV-related disparities is high sexually transmitted infection (STI) rates among AI/AN, which can facilitate the acquisition and transmission of HIV [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“There Is a Lot of Practice in Not Thinking about That”: Structural, Interpersonal, and Individual-Level Barriers to HIV/STI Prevention among Reservation Based American Indians

Armenta

Kellogg

Montoya

et al. 2021

IJERPH

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American Indians (AI) face significant disparities in HIV/STI morbidity and mortality, and historical, structural, interpersonal, and individual level barriers stymie prevention efforts. The objective of this paper is to examine barriers to HIV/STI prevention among reservation-based AI. We conducted face-to-face qualitative interviews with 17 reservation-based AI community leaders and community members in Southern California on HIV/STI knowledge and attitudes and barriers to prevention. The disruption of traditional coping mechanisms and healing processes were compromised by historical trauma, and this allowed stigmas to exist where they did not exist before. This impacted access to healthcare services and trust in medicine, and is linked to individuals adopting negative coping behaviors that confer risk for HIV/STI transmission (e.g., substance use and sexual behaviors). Most of the participants reported that HIV/STIs were not discussed in their reservation-based communities, and many participants had a misperception of transmission risk. Stigma was also linked to a lack of knowledge and awareness of HIV/STI’s. Limited available services, remoteness of communities, perceived lack of privacy, and low cultural competency among providers further hindered the access and use of HIV/STI prevention services. These findings highlight the need to address the historical, structural, and interpersonal factors impacting individual-level behaviors that can increase HIV/STI transmission among reservation-based AIs. Prevention work should build on community strengths to increase HIV/STI knowledge, reduce stigma, and increase access to preventative care while using culturally grounded methodologies.

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“…There is little published research about the sociodemographic characteristics of AI/AN people at risk for and living with HIV. 7,8 One possible reason is the potentially very small sample sizes that arise when calculating estimates specific to AI/AN people. To our knowledge, no peer-reviewed articles on CDC-funded HIV testing for this group have been published.…”

mentioning

confidence: 99%

CDC-Funded HIV Testing and Linkage to HIV Medical Care Among American Indian and Alaska Native People in the United States, 2014-2020

Moore

Williams²,

Marano-Lee

et al. 2022

Public Health Rep

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Objective: An estimated 1 in 5 American Indian and Alaska Native (AI/AN) adults living with HIV are unaware of their status. We investigated HIV testing among AI/AN people receiving a Centers for Disease Control and Prevention (CDC)–funded test from 2014 through 2020. Methods: We analyzed data on CDC-funded HIV tests reported by health departments and community-based organizations in the United States. We described the number of CDC-funded HIV tests, the percentage of people with newly and previously diagnosed HIV, and linkage to HIV medical care within 90 days of diagnosis. Results: CDC-funded health departments and community-based organizations provided 99 227 HIV tests to AI/AN people during 2014-2020. Seven hundred thirty-five (0.7%) AI/AN people were diagnosed with HIV; 361 (0.4%) were newly diagnosed, 319 (0.3%) had a previous HIV diagnosis, and 55 (0.1%) had a previously unknown HIV status. Positivity for new diagnoses was highest among the following population groups tested in non–health care settings: men who had sex with men (MSM; n = 72, 1.2%), MSM who inject drugs (n = 12, 1.8%), and transgender people (n = 12, 1.5%). The percentage of linkage to HIV medical care was 80.6% for newly diagnosed people and 78.2% for previously diagnosed people. Conclusions: MSM AI/AN, including those who inject drugs, and transgender AI/AN may benefit from prioritized HIV testing. All AI/AN people with HIV, whether newly or previously diagnosed, should rapidly link to HIV medical care and receive support throughout the continuum of care. Our findings can inform which AI/AN population subgroups may benefit from enhanced HIV testing efforts and interventions.

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Assessing New Diagnoses of HIV Among American Indian/Alaska Natives Served by the Indian Health Service, 2005-2014

Cited by 7 publications

References 7 publications

Trends in Indicators of Injection Drug Use, Indian Health Service, 2010-2014

Trends in Indicators of Injection Drug Use, Indian Health Service, 2010-2014

“There Is a Lot of Practice in Not Thinking about That”: Structural, Interpersonal, and Individual-Level Barriers to HIV/STI Prevention among Reservation Based American Indians

CDC-Funded HIV Testing and Linkage to HIV Medical Care Among American Indian and Alaska Native People in the United States, 2014-2020

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