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Objectives: To describe HIV and AIDS among American Indians/Alaska Natives (AI/ AN) in the USA through 2000., Design: An epidemiologic profile was constructed using HIV/AIDS surveillance, sexually transmitted disease (STD), and seroprevalence data., Results: Although AIDS among AI/AN represents < 1% of cumulative AIDS cases in the USA, in 2000 the AIDS incidence rate (cases per 100,000 population) for AI/AN (11.9) was higher than that for whites (7.3). AI/AN had high rates of chlamydia, gonorrhea, and syphilis from 1996 through 2000; among all females, AI/AN females had the second highest rates of chlamydia, gonorrhea, and syphilis reported during this time period. Of all AIDS cases among AI/AN, 70% were reported by 10 states., Conclusions: These data demonstrate that the impact of STDs and the potential for an impact of HIV/AIDS among AI/AN are greater than indicated by the relatively small number of AIDS cases in this population. Additional mechanisms are needed to fill gaps in the available data. Coordination among the complex network of healthcare providers, tribes, and federal, state, and local health agencies is needed to improve delivery of information about HIV/AIDS to AI/AN and to ensure access to HIV prevention and treatment programs for AI/AN.

The objective of this study was to verify the mode of exposure to the human immunodeficiency virus (HIV) among cases who obtained acquired immunodeficiency syndrome (AIDS) through heterosexual contact and to determine the proportion of cases initially reported with no risk but whose exposure may have been heterosexual. Adults aged ≥13 years with AIDS, diagnosed from 1992 through 1995 with heterosexual risk or no risk at six US study sites (Alabama, California, Florida, New Jersey, New York City, and Texas), were eligible. Heterosexual risk was validated in 82% (1,610/1,952) of the heterosexual cases. Men were more likely than women to have a risk other than heterosexual (24% vs. 13%, χ2 p < 0.01). An HIV risk was identified for 351 (55%) of those cases with no risk, and men were more likely than women to remain without risk (48% vs. 38%, χ2 p = 0.02). Of the 415 men with no risk, 215 (52%) were reclassified: 94 (44%) were men who had sex with men, 61 (28%) were injection drug users, 48 (22%) had a heterosexual risk, and 12 (6%) had other exposures. Of the 219 women with no risk, 136 (62%) were reclassified: 82 (60%) had a heterosexual risk, 47 (35%) were injection drug users, and 6 (4%) had infection associated with transfusion. In conclusion, most cases reported with heterosexually acquired AIDS had Valid heterosexual risk exposures. Am J Epidemiol 1999;149:75–84. [ABSTRACT FROM PUBLISHER]