Individual and Partnership-Level Characteristics of Two-Spirit Native Americans that may Increase Risk of HIV Transmission

Susan L. Cassels, University of Washington
Cynthia Pearson, University of Washington
Jane Simoni, University of Washington
Martina Morris, University of Washington
Karina Walters, University of Washington

American Indians and Alaska Natives ranked third in rates of HIV/AIDS diagnosis after African Americans and Hispanics, and recent evidence suggests that sexual network dynamics, including concurrency and partnership mixing, play an important role in racial disparities in HIV in the US. We used data from the first national study of two-spirit Natives (i.e. LGBT individuals) to describe partnership-level characteristics and to identify relational formations that are potentially related to high risk of HIV transmission or acquisition. We found that more than half of the respondents reported at least some concurrency; while12% reported three overlapping partnerships. Mean concurrency was significantly higher among respondents who were HIV-positive. Partnership duration and mixing varied by gender, education, race, sexual orientation and income. Lastly, prevalence of unprotected sex acts was significantly higher for respondents with White partners than with other Native partners. These findings may identify potential strategies for HIV prevention efforts targeting at-risk populations.