HIV Among Native Hawaiians and Other Pacific Islanders in the United States and 6 Dependent Areas

From 2011 to 2015, HIV diagnoses:

• Increased 51% (from 55 to 83) among NHOPI overall.
• Increased 50% (from 42 to 63) among NHOPI gay and bisexual men.

Diagnoses of HIV Infection among Adult and Adolescent Native Hawaiians and Other Pacific Islanders,
by Transmission Category, 2016

Source: CDC. Diagnoses of HIV infection in the United States and dependent areas, 2016. HIV Surveillance Report 2017;28

Living With HIV

• In 2015, an estimated 1,100 NHOPI were living with HIV in the United States. Of those, 82% had received a diagnosis.
• Among NHOPI living with HIV in 2014, 60% received HIV medical care, 43% were retained in HIV care, and 50% had a suppressed viral load.^d

Prevention Challenges

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, sharing injection drug equipment with someone who has HIV, or lack of awareness of HIV status. People who do not know they have HIV cannot take advantage of HIV care and treatment and may unknowingly pass HIV to others. Factors that particularly affect NHOPI include:

• Socioeconomic factors. 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. NHOPI cultural customs, such as not 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. Limited research about NHOPI health and HIV infection and small population numbers have resulted in a lack of targeted prevention programs and behavioral interventions for this population.
• Data limitations. 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. This could lead to an underestimation of HIV infection in this population.

What CDC Is Doing

CDC and its partners are pursuing a high-impact prevention approach to 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 provide an array of culturally sensitive services, including HIV care and testing, HIV education, counseling, behavioral health, substance abuse, and social support services.
• CDC’s Capacity Building Assistance for High-Impact HIV Prevention funds technical assistance providers to support capacity building; the Asian and Pacific Islander American Health Forum and the Asian and Pacific Islander Wellness Center are funded grantees to provide capacity building.
• The CDC publication Effective HIV Surveillance Among Asian Americans and Native Hawaiians and Other Pacific Islanders outlines successful HIV data collection activities for health departments in states with high concentrations of NHOPI.
• Through its Act Against AIDS campaigns, CDC provides messages about HIV treatment and prevention. For example,
  • Doing It encourages all adults to get tested for HIV and know their status.
  • Let’s Stop HIV Together raises awareness about HIV and fights stigma.
  • HIV Treatment Works encourages people living with HIV to stay in care.

^a HIV and AIDS diagnoses indicate when a person is diagnosed with HIV or AIDS, not when the person was infected.
^b Dependent areas include American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, the Republic of Palau, and the US Virgin Islands.
^c The term male-to-male sexual contact 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.
^d People are considered retained in care if they get two viral load or CD4 tests at least 3 months apart in a year. (CD4 cells are the cells in the body’s immune system that are destroyed by HIV.) Viral suppression is based on the most recent viral load test.