HIV Among Native Hawaiians and Other Pacific Islanders
April 29, 2015
- HIV affects NHOPI in ways that are not always apparent because of their small population size.
- One in four NHOPI living with HIV are unaware of their infection.
- NHOPI cultural taboos on talking about sex may interfere with HIV prevention.
National estimates show that Native Hawaiians and Other Pacific Islanders (NHOPI) in the United States and dependent areas1,2 represent a very small proportion of HIV infections, compared with other races/ethnicities.
New HIV Infections3
- In 2010, NHOPI accounted for less than 1% (70) of the estimated 47,500 new HIV infections in the United States.
- The estimated number of new HIV infections among NHOPI remained stable from 2008 to 2010.
HIV and AIDS Diagnoses4 and Deaths
In the United States:
- In 2013, NHOPI had the fourth highest estimated rates of HIV diagnoses (12.7 per 100,000 people) in the United States by race/ethnicity, behind blacks/African Americans, Hispanics/Latinos,5 and those of multiple races.
- In 2013, the rate of HIV diagnoses in NHOPI was almost twice as high as rates among whites.
- In 2011, an estimated 1,200 NHOPI were living with HIV. Of those, 75% had been diagnosed.
In the United States and six dependant areas:
- In 2013, less than 1% (67) of 48,145 estimated HIV diagnoses were among NHOPI; 52 diagnoses were in men, and 15 were in women.
- In 2013, 47 of the 52 estimated HIV diagnoses among NHOPI men were attributed to male-to-male sexual contact, and 13 of the estimated 15 HIV diagnoses among NHOPI women were attributed to heterosexual contact.6
- In 2013, an estimated 37 NHOPI were diagnosed with AIDS.
- By the end of 2012, an estimated 361 NHOPI ever diagnosed with AIDS had died.
Estimated Diagnoses of HIV Infection Among Male (Left) and Female (Right) Adult and Adolescent Native Hawaiians/Other Pacific Islanders, by Transmission Category, 2013 -- United States and 6 Dependent Areas
* Because totals were calculated independently of the values of the subpopulation, the subpopulation values do not sum to the total. Numbers less than 12 should be interpreted with caution because they have underlying relative standard errors greater than 30% and are considered unreliable.
There are some behaviors that put everyone at risk for HIV, including NHOPI. These include having vaginal or anal sex without a condom or without being on medicines that prevent HIV, or sharing injection drug equipment with someone who has HIV. Other factors that particularly affect NHOPI include:
- Lack of awareness of HIV status can affect HIV rates in communities. Nationally, approximately 14% of US adults and adolescents living with HIV infection in 2011 were unaware of their HIV infection. However, 25% of adult and adolescent NHOPI with HIV were unaware of their infection.
- 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 those that prioritize obligations to family (reputation and ethnic pride) and taboos on intergenerational sexual topics and sexual health discussion, 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 has resulted in few 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 (NHAS), and maximize the effectiveness of current HIV prevention methods. Activities include:
View the bibliography.
CDC HIV Website
CDC Act Against AIDS Campaign
- Dependent areas: American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, the Republic of Palau, and the US Virgin Islands.
- Certain data are presented for the United States only. Incidence estimates are available for the 50 states and the District of Columbia only. Estimated subpopulation rates of HIV and AIDS diagnoses by race/ethnicity for the 6 US dependent areas are not available because the US Census Bureau does not collect information from all dependent areas.
- New HIV infections refer to HIV incidence or the number of people who are newly infected with HIV in a given time period, whether they are aware of their infection or not.
- 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.
- Heterosexual contact with a person known to have, or to be at high risk for, HIV infection.
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