Risk Factors for HIV Disease Progression in a Rural Southwest American Indian Population

Sociocultural factors cause HIV/AIDS to progress more rapidly among Native American patients.

From 1992 to 2003, the number of American Indian and Alaskan Natives with HIV/AIDS doubled; this cross-sectional study explored the progression of HIV/AIDS according to sociocultural, economic and demographic variables within the Navajo nation.

The Four Corners American Indian Circle of Services Collaborative (4CC) serves Navajo HIV/AIDS patients. Researchers recruited patients under case management through the Navajo AIDS Network (NAN), a partner of 4CC. The study defined HIV/AIDS progression as increases in HIV ribonucleic acid (RNA) viral loads and decreases in CD4-cell counts. Data were collected on participants' employment status, use of traditional Navajo medicine, substance abuse and other characteristics.

Key Findings:

  • CD-4 counts were lower in patients who had been incarcerated or abused alcohol within the previous 12 months.
  • An income below $1,000 per month increased risk for more rapid disease progression.

This study reviewed clinical chart data for HIV-positive Navajos; case managers conducted interviews to assess risk factors for disease progression. Many Native Americans live in rural areas where health services are unavailable. Future HIV/AIDS interventions in Native American communities can incorporate the findings presented here.