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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update
UNITED STATES: How Sexual Stigma Is Undermining HIV Treatment on American Indian Reservations
By Sy Mukherjee
May 23, 2013
Think Progress (05.21.2013)

The Indian Health Service (IHS) reported that cultural stigma against homosexuality and HIV prevents many Navajo tribe members from adhering to HIV treatment. HIV incidence among the Navajo is relatively low due to the seclusion of the reservation, but new cases surged by 20 percent from 2011 to 2012, according to IHS Chief Medical Officer Dr. Susan V. Karol. Men who have sex with men (MSM) comprised almost half of new HIV cases on the reservation. Melvin Harrison, executive director of the Navajo AIDS Network (NAN), described how stigma against homosexuality and HIV affects health-seeking behavior among the Navajo. Approximately 75 percent of NAN clients are “closeted” MSM, according to Harrison. Most NAN clients have not told their family and friends about their diagnosis because they fear family rejection and shunning. One HIV-infected man reported that his mother would not hug him and fed him from disposable plates after learning of his diagnosis. The need to remain silent is a major barrier to treatment compliance, since family and community awareness are instrumental in helping patients follow through with HIV treatment and checkups. Although it is not clear why, American Indians with HIV or AIDS have a lower survival rate than other racial groups.

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