Epidemiological Profile of HIV/AIDS in Minnesota
Risk Populations: American Indians
HIV/AIDS Prevalence among American Indians
As of December 31st 2013, there were 132 American Indians living with HIV/AIDS in Minnesota. Although this only accounts for 2 percent of persons living with HIV/AIDS in Minnesota, American Indian persons have more than twice the rate of people living with HIV than white (1), non-Hispanic persons (216.7 per 100,000 persons and 88.6 per 100,000 persons respectively).
While the number of cases among American Indians in Minnesota has been relatively stable and low it is important to note this group has been found to have their race misclassified often by providers. A study by the Centers for Disease Control and Prevention (CDC) of the HIV/AIDS Surveillance data for five states found that thirty percent of American Indian cases were misclassified, mostly as white (Bertolli et al., 2007). It is possible that similar misclassification occurs in the Minnesota data and impacts the reported number of cases for American Indians in the state.
HIV Diagnoses among American Indians
Over the past ten years, new infections among American Indians has remained relatively low with an average of 7 new diagnoses a year with lows of 4 diagnoses in 2005 and 2011 and a high of 12 diagnoses in 2010. In 2013, there were 6 HIV/AIDS diagnoses among American Indians, five male and one female.
Gender and Mode of Exposure
Of the 13 American Indian males diagnosed between 2011 and 2013, 50% had an estimated mode of exposure of MSM, 30% IDU, 10% MSM/IDU, and 8%heterosexual contact with someone with or at risk for HIV infection. Of the 11 American Indian females diagnosed between 2011 and 2013, % had an estimated mode of exposure of heterosexual contact with someone with or at risk for HIV infection and 10% IDU.
Compared to other race/ethnicities, HIV positive American Indian persons living with HIV/AIDS have a higher percentage of people living in Greater Minnesota (outside the 11-county metro area) at 20%. This is not surprising since there are several Indian reservations in Greater Minnesota.
HIV Treatment Cascade among American Indians
There were 112 HIV positive American Indians included in the HIV Treatment Cascade analyses. Compared to the overall treatment cascade in Minnesota, American Indians have a higher percentage in retention in care, but lower percent of the population virally suppressed.
There were 10 diagnoses among American Indians in 2012 that were included in the linkage to care calculation. American Indians have the lowest linkage to care rate than any other racial/ethnic group. Eighty percent of American Indian diagnosed in 2012 linked to care (had a CD4 or viral load test done) within three months of diagnosis. It is important to note the numbers of HIV cases in this community are quite small, particularly for linkage to care measure and should be interpreted carefully.
(1) Bertolli J, Lee LM, Sullivan PS, AI/AN Race Ethnicity Validation Workgroup. Racial Misclassification of American Indians/Alaska Natives in the HIV/AIDS Reporting Systems of Five States and One Urban Health Jurisdiction, U.S., 1984-2002. Public Health Reports, 122(3):382-392, 2007