title: HIV-infected American Indians/Alaska natives in the Western United States.
abstract: OBJECTIVE
  We sought to describe HIV-infected American Indians/Alaska Natives (AI/ AN) in the western United States.
  
  
  METHODS
  One hundred fifty-one Al/AN and 11,344 non-AI/AN HIV-infected patients in Seattle, Denver, and Los Angeles were followed by medical record review from January 1989 through June 1998 for the Adult/Adolescent Spectrum of HIV-related Diseases study.
  
  
  METHODS
  Bivariate and multivariate statistical analyses comparing HIV-infected Al/AN and non-AI/AN were performed.
  
  
  RESULTS
  There were 103 (68%) male and 48 (32%) female Al/AN patients, while non-Al/AN patients were 86% male and 14% female (P<.001). The median age among AI/ AN was 32 years vs. 34 years among non-AI/AN (P = .05). Male Al/AN were more likely than male non-AI/AN to report the dual risks of having sex with men and injection drug use (32% vs. 14%; P<.001) compared with other HIV risks. Median CD4 cell counts were higher in Al/AN than in non-AI/AN (P< or =.001). AI/AN were more likely to be diagnosed with an acute sexually transmitted disease (STD) than were non-AI/AN (11% vs. 4%, P<.001). Five (6%) of AI/AN with AIDS had active pulmonary tuberculosis (TB) compared with 132 (2%) of non-AI/AN with AIDS (P = .02). While 52% of Al/AN and 44% of non-AI/AN had a psychiatric illness (P = .04), and 13% of AI/AN, and 6% of non-AI/ AN had suicidal ideation (P<.001), these associations became non-significant in analyses stratified by alcohol and drug use (P>.05). In adjusted models, survival and progression to opportunistic infection or CD4 cell count less than 200/mm3 did not significantly differ between Al/AN and non-AI/AN.
  
  
  CONCLUSIONS
  HIV-infected AI/AN were younger than non-AI/AN, and a greater proportion of Al/AN were women relative to non-AI/AN. AI/AN were more likely to be diagnosed with STDs and TB. In adjusted models, their risks of death and developing AIDS did not significantly differ from those of non-AI/AN.
authors.affiliation: Seattle King County Department of Public Health and University of Washington School of Public Health, Seattle, Washington, USA. diamondc@uci.edu
authors.forename: C
authors.initials: C
authors.lastname: Diamond
authors.forename: A
authors.initials: A
authors.lastname: Davidson
authors.forename: F
authors.initials: F
authors.lastname: Sorvillo
authors.forename: S
authors.initials: S
authors.lastname: Buskin
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D003120:Colorado / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology* / Q000401:mortality; D006297:Health Services Accessibility; D006801:Humans; D007198:Indians, North American; D004930:Inuit; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000150:complications; D008875:Middle Aged; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000150:complications; D014861:Washington / Q000453:epidemiology