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Running head: NATIVE AMERICANS AND HUMAN IMMUNODEFICIENCY VIRUS 1

Native Americans and the Human Immunodeficiency Virus

Student’s Name

National University

NATIVE AMERICANS AND HUMAN IMMUNODEFICIENCY VIRUS 2

Paper TitleNative Americans and Human Immunodeficiency Virus

Native Americans are the indigenous people of North, South, and Central America.

Native Americans have been abused by governments for centuries by oppression and conquering

of tribal land. This abuse has left them vulnerable to unique health disparities. One major

disparity is the ongoing problem of the human immunodeficiency virus or HIV. The Native

American population has seen an increase in HIV cases from 1990 to 2001 of over 900%, this

makes them the most rapidly growing group for infection (Dennis, 2009). HIV was the ninth

cause of death for Native Americans aged 25-34 in 2010; they have been shown to have poorer

survival rates compared to all other races after diagnosis with HIV (Centers for disease control

and prevention (CDC), 2013). While ethnicity is not a risk factor for any disease there are many

other factors that lead to higher infection rates. This paper will review what makes the Native

American population so vulnerable to the HIV pandemic.

Firstly when considering the Native American population, demographics and history

have to be addressed because of the impact it has made on their culture. The term Native

American is used to describe a varying population of approximately 5.2 million people that are a

part of over 500 individual tribes (CDC, 2013). Each tribe behaves uniquely and has its own

culture, and with that their own views on healthcare. Even with many different tribes there is a

common feeling of oppression that most Native Americans feel from the years of maltreatment.

Native Americans fell victim to many diseases that were brought over from Europe, this

weakened their numbers to the point where they could not defend themselves against the theft of

their land (Weaver, 1999). This loss of land has had a negative impact on Native Americans and

has lead to the loss of culture. According to the United States Census Bureau(2011)., only 22%

of Native Americans live on reservations as of 2010 (2011). Loss of land was not the only way

Comment [AI1]: Citation needed

Comment [AI2]: Prove!

NATIVE AMERICANS AND HUMAN IMMUNODEFICIENCY VIRUS 3

that Native Americans were abused. Native Americans have been subjected to unethical research

practices and substandard medical care since the early 1900s, this have left them hesitant about

using western healthcare (Dennis, 2009). Loss of land and years of racism and abuse has caused

serious trauma that negatively impacts Native American culture today.

The forced loss of land and genocide has led to an effect called “soul wound” on the

Native American people (Dennis, 2009). The “soul wound” felt by the Native American people

is one factor that culturally influences the increased HIV infection rate. As Mary Kate Dennis

notes, “historical trauma and trauma from interpersonal violence contribute to risk factors for

HIV infection” (Author?, 2013, page number?).

Another cultural factor is the belief that HIV does not affect Native Americans and that

they are not at risk for contracting the virus (Weaver, 1999). This belief leads to unsafe sex

practices and needle sharing during traditional ceremonies, which in turn can lead to HIV

infection. Native Americans also are not accepting of same sex relationships and refer to gay or

lesbian people as “two spirit” (Dennis, 2009). This leads to people not getting medical care when

ill over fear of reprisal about their sexual orientation. Because they keep their sexual preferences

a secret, gay Native Americans are more likely to use the gay bar scene to meet partners which

leads to exposure to alcohol and drug use which can lead to unsafe sex (Dennis, 2009). Seventy

five percent of all new HIV infections in 2011 were attributed to men having sex with men

(CDC, 2013). Native American culture is only a part of the reason why the HIV infection rate is

increasing among this population.

The socioeconomic status of Native Americans is also a concern. The average household

income in 2010 was $35,062 for Native Americans compared to $50,046 for the nation as a

whole (United States Census Bureau, 2011). This leads to a less proportion of Native Americans

Formatted: Indent: First line: 0.5″

NATIVE AMERICANS AND HUMAN IMMUNODEFICIENCY VIRUS 4

having health insurance. Approximately 29% of Native Americans did not have health insurance

compared to 15.5% of the nation in 2010 (United States Census Bureau, 2011). Native

Americans do have government funded healthcare available to them but as mentioned earlier

only 22% of Native Americans live on reservations so access may be limited to those facilities.

Even if they have access to the federally funded Indian Health Service there is a general mistrust

of western medicine due to years of abuse suffered in the hands of western doctors. For example

in the 1920s over 20,000 unnecessary eye procedures were preformed that lead to eye disease

such as blindness and in the 1970s, up to 40 percent of Native American women were sterilized

without informed consent (Dennis, 2009). This leads to many Native Americans not receiving

any healthcare or waiting until an ailment is life threatening.

Other health disparities also correlate and make Native Americans overall more

susceptible to HIV. Having sexually transmitted diseases increase the susceptibility of

contracting HIV and Native Americans have the second highest rates of all races for gonorrhea,

chlamydia, and syphilis (CDC, 2013). HIV and sexually transmitted diseases can both be

contracted through unsafe sex so it makes sense that they are positively correlated.

Alcoholism and substance abuse is also a huge risk factor for contracting HIV.

According to Dennis (2013) “Native American women are more likely to be injection drug users

than any other ethnic group” (page number?2013). Alcoholism is also prevalent in Native

Americans which leads to riskier sexual behaviors. Mental health also needs to be noted. The

“soul wound” mentioned earlier has been correlated with poor mental health and Native

Americans suffer from ailments such as historical trauma response, post traumatic stress

disorder, alienation, and depression at higher rates than other groups which leads to increased

risk for HIV (Dennis, 2009).

NATIVE AMERICANS AND HUMAN IMMUNODEFICIENCY VIRUS 5

There are many factors that leave the Native Americans more vulnerable to HIV such as

historical trauma, socioeconomic status, mistrust of western healthcare and other health

disparities. Hopefully future education about safe sex practices and needle exchanges can help

bring down the number of new infections of HIV. To be successful though, a program would

have to look at Native American culture as a whole and take into consideration the historical

trauma that this group has suffered before members can begin to gain confidence in western

healthcare once again. Some Native Americans say HIV was predicted long ago and will be the

downfall of all Native Americans and others say they have the power to stop the death. For the

sake of all future generations, now is the time to act and stop HIV in its tracks (Weaver, 1999).

Comment [AI3]: Comparison to majority or other groups is limited/missing

NATIVE AMERICANS AND HUMAN IMMUNODEFICIENCY VIRUS 6

References

Centers for Disease Control and Prevention (2013, Mar 27). HIV/AIDS among American Indians

and Alaska Natives. Retrieved from

http://www.cdc.gov/hiv/resources/factsheets/aian.htm. Date accessed ?

Dennis, M. K. (2009). Risk and Protective Factors for HIV/AIDS in Native Americans:

Implications for Preventive Intervention. Social Work, 54(2), 145-154.

United States Census Bureau (2011, Nov 1). American Indian and Alaska Native Heritage

Month: November 2011. Retrieved from

http://www.census.gov/newsroom/releases/archives/facts_for_features_special_editions/c

b11-ff22.html. Date accessed?

Weaver, H. N. (1999). Through Indigenous Eyes: Native Americans and the HIV Epidemic.

Health & Social Work, 24(1), 27-34.

NATIVE AMERICANS AND HUMAN IMMUNODEFICIENCY VIRUS 7

Outstanding

Achievement

Commendable

Achievement

Marginal

Achievement

Unsatisfacto

Achieveme

Faili

Identified a cultural

group

 Description of the

target group

 historical

perspective

 Demographics

Clearly defines

cultural group in

terms of history,

geography and

population

characteristics

Clearly defines a

cultural group

without adequately

describing some

characteristics

Defines a cultural

group without

adequately

describing many

important

characteristics

Lists a

cultural

group

without

further

definition

miss

ing

Identified health

disparities

 Health issues and

disparities

 Morbidity and

mortality rates

 Patterns of Care

 Access to care

 Mental health

issues

20%

Clearly identifies

disparities by

comparing

descriptive

epidemiology of

group to majority

group or other group

15%

Clearly identifies

disparities using

descriptive

epidemiology

however without

adequate

comparisons

10%

Correctly lists

health disparities

without adequate

descriptive

epidemiology

Lists health

disparities

incorrectly

miss

ing

Identified health

behaviors

 Preventive and

protective health

behaviors

 Sick-role behaviors

 Illness behaviors

 Societal health

behaviors

20%

Clearly describes all

common health

behaviors with

supporting evidence

15%

Clearly describes

most common

health behaviors

missing some