Background: Rates of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) among American Indians (AIs) are reportedly below those for the general population, yet rates of other sexually transmitted diseases (STDs), calculated from data in 14 western states, are higher--58% higher for syphilis and 2.5 times the national average for chlamydia, These findings suggest that HIV/AIDS reporting among AIs is incomplete. Methods: Using all HIV/AIDS-associated International Classification of Disease, Ninth Revision-CM codes, we conducted an electronic search of Indian Health Service (IHS) and tribal facilities within IHS’s Albuquerque Service Area (ASA) and in New Mexico to identify all possible cases of HIV/AIDS diagnosed during 1980--2000. Identified patients were hand-matched by name and birthdate with the HIV/AIDS database of New Mexico’s Department of Health (NMDOH). We reviewed charts for patients not found in NMDOH’s database and determined reasons for nonreporting. Results: Initial matching demonstrated 27 (27%) of 101 found through the IHS search were not reported to NMDOH. Record reviews revealed eleven (41%) HIV-negative patients were miscoded as HIV positive, as were five (18%) with no evidence of HIV disease or testing in their charts. Four (15%) were nonresidents, two (7%) were not reportable by criteria extant when last seen, and two ( 7%) were reportable. Three charts were unavailable. Conclusions: Although HIV/AIDS reporting for AIs was hypothesized to be incomplete, we found only two unreported cases from IHS facilities. Differences between HIV and STD rates among AIs in New Mexico cannot be explained by incomplete reporting.
Learning Objectives: At the conclusion of the session, the participant will be able to: 1. List two obstacles affecting the completeness of HIV surveillance among American Indians. 2. Recognize the potential for spread of HIV infection in some American Indian/Alaska Native communities, as evidenced by high rates of other sexually transmitted diseases. 3. Recognize that the disparity between reported rates of STDs and of HIV infection may reflect a window of opportunity for intevention to prevent the spread of HIV infection in American Indian/Alaska Native communities.
Keywords: Surveillance, HIV/AIDS
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: none
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.