HIV Among Native Hawaiians and Other Pacific Islanders in the United States
February 13, 2017
- Native Hawaiians and Other Pacific Islanders (NHOPI) represented less than 1% of new HIV diagnoses in the United States in 2014.
- From 2005 to 2014, the annual number of HIV diagnoses declined 5% overall. Among NHOPI gay and bisexual men, HIV diagnoses increased 27%.
- Nearly one-quarter of adult and adolescent NHOPI living with HIV do not know it.
Although NHOPI account for a very small percentage of new HIV diagnoses, HIV affects NHOPI in ways that are not always apparent because of their small population sizes.
HIV and AIDS Diagnoses1
- In 2014, an estimated 58 NHOPI were diagnosed with HIV, representing less than 1% of new HIV diagnoses in the United States. NHOPI make up 0.2% of the population.
- NHOPI had the fourth-highest estimated rates of HIV diagnoses (10.6 per 100,000 people) in the United States by race/ethnicity, behind blacks/African Americans, Hispanics/Latinos,2 and those of multiple races.
- Gay and bisexual men3 accounted for 78% (45) of the estimated HIV diagnoses among NHOPI in 2014.
- Overall, the annual number of HIV diagnoses declined 5% from 2005 to 2014. Among NHOPI gay and bisexual men, HIV diagnoses increased 27%.
- In 2014, an estimated 19 NHOPI were diagnosed with AIDS in the United States.
Living With HIV
- In 2012, an estimated 1,300 NHOPI were living with HIV in the United States. Of those, 23% had not been diagnosed. By comparison, 13% of all Americans living with HIV are undiagnosed.
- Among NHOPI who were diagnosed with HIV in 2013, 70% were linked to care within 3 months.4
- Among NHOPI diagnosed with HIV in 2011 or earlier and alive at the end of 2012, 49% were retained in HIV care.
- Among NHOPI who were living with HIV at year-end 2012, 47% had a suppressed viral load.5
Some behaviors put everyone at risk for HIV, including NHOPI. These behaviors include having vaginal or anal sex without a condom or without medicines to prevent or treat HIV, or sharing injection drug equipment with someone who has HIV. Other factors particularly affect NHOPI:
- Lack of awareness of HIV status can affect HIV rates in communities. Nearly one-quarter of adult and adolescent NHOPI living with HIV do not know it.
- Socioeconomic factors such as poverty, inadequate or no health care coverage, language barriers, and lower educational attainment among NHOPI may contribute to lack of awareness about HIV risk and higher-risk behaviors.
- Cultural factors may affect the risk of HIV infection. NHOPI cultural customs, such as norms about talking about sex across generations, may stigmatize sexuality in general, and homosexuality specifically, as well as interfere with HIV risk-reduction strategies, such as condom use.
- Limited research about NHOPI health and HIV infection and small population numbers have resulted in a lack of targeted prevention programs and behavioral interventions in this population.
- The low reported number of HIV cases among NHOPI may not reflect the true burden of HIV in this population because of race/ethnicity misidentification that could lead to the underestimation of HIV infection in this population.
What CDC Is Doing
CDC and its partners are pursuing a high-impact prevention approach to advance the goals of the National HIV/AIDS Strategy: Updated to 2020 and maximize the effectiveness of current HIV prevention methods.
- CDC provides support and technical assistance to health departments and community-based organizations to deliver prevention programs for NHOPI, such as The Banyan Tree Project.
- HIV Prevention Projects for Community-Based Organizations funds The Asian Pacific AIDS Intervention Team and the Asian and Pacific Islander Wellness Center, which provides an array of culturally sensitive services, including HIV care and testing, HIV education, counseling, behavioral health, substance abuse, and social support services.
- Capacity Building Assistance for High-Impact HIV Prevention provides technical assistance in capacity building to the Asian and Pacific Islander American Health Forum and the Asian and Pacific Islander Wellness Center.
- The CDC publication Effective HIV Surveillance Among Asian Americans and Native Hawaiians and Other Pacific Islanders (April 2013) outlines successful HIV data collection activities for health departments in states with high concentrations of NHOPI.
- Through its Act Against AIDS campaigns, CDC provides effective and culturally appropriate messages about HIV treatment and prevention. For example,
- CDC. Diagnoses of HIV infection and AIDS in the United States and dependent areas, 2014. HIV Surveillance Report 2016;26. Accessed March 4, 2016.
- CDC. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data -- United States and 6 dependent areas -- 2013. HIV Surveillance Supplemental Report 2016;20(2). Accessed March 4, 2016.
- Cook WK, Chung C, Ve'e T. Native Hawaiian and Pacific Islander Health Disparities. San Francisco, CA: Asian & Pacific Islander American Health Forum; August 2010.
- Takahashi LM, Kim AJ, Sablan-Santos L, et al. HIV testing behavior among Pacific Islanders in Southern California: exploring the importance of race/ethnicity, knowledge, and domestic violence. AIDS Educ Prev 2011;23(1):54-64. PubMed abstract.
- DiStefano AS, Hui B, Barrera-Ng A, et al. Contextualization of HIV and HPV risk and prevention among Pacific Islander young adults in Southern California. Soc Sci Med 2012;75(4):699-708.
- Adih WK, Campsmith M, Williams CL, Hardnett FP, Hughes D. Epidemiology of HIV among Asians and Pacific Islanders in the United States, 2001-2008. J Int Assoc Physicians AIDS Care (Chic) 2011;10(3):150-9. PubMed abstract.
- HIV and AIDS diagnoses refer to the estimated number of people diagnosed with HIV infection, regardless of stage of disease at diagnosis, and the estimated number of people diagnosed with AIDS, respectively, during a given time period. The terms do not indicate when they were infected.
- Hispanics/Latinos can be of any race.
- The term men who have sex with men is used in CDC surveillance systems. It indicates a behavior that transmits HIV infection, not how individuals self-identify in terms of their sexuality. This fact sheet uses the term gay and bisexual men.
- In 27 states and the District of Columbia (the areas with complete lab reporting by December 2014).
- A person with a suppressed viral load has a very low level of the virus. That person can stay healthy and has a dramatically reduced risk of transmitting the virus to others.
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