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. 2007 May-Jun;122(3):382-92.
doi: 10.1177/003335490712200312.

Racial misidentification of American Indians/Alaska Natives in the HIV/AIDS Reporting Systems of five states and one urban health jurisdiction, U.S., 1984-2002

Jeanne Bertolli  1 , Lisa M Lee, Patrick S Sullivan; AI/AN Race /Ethnicity Data Validation Workgroup
Affiliations
Free PMC article

Racial misidentification of American Indians/Alaska Natives in the HIV/AIDS Reporting Systems of five states and one urban health jurisdiction, U.S., 1984-2002

Jeanne Bertolli et al. Public Health Rep. 2007 May-Jun.
Free PMC article

Abstract

Objectives: We examined racial misidentification of American Indians/Alaska Natives (AI/AN) reported to the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) Reporting Systems (HARS) of five U.S. states and one county.

Methods: To identify AI/AN records with misidentified race, we linked HARS data from 1984 through 2002 to the Indian Health Service National Patient Information and Reporting System (NPIRS), excluding non-AI/AN dependents, using probabilistic matching with clerical review. We used chi-square tests to examine differences in proportions and logistic regression to examine the associations of racial misidentification with HARS site, degree of AI/AN ancestry, mode of exposure to HIV, and urban or rural location of residence at time of diagnosis.

Results: A total of 1,523 AI/AN individuals was found in both NPIRS and HARS; race was misidentified in HARS for 459 (30%). The percentages of racially misidentified ranged from 3.7% (in Alaska) to 55% (in California). AI/AN people were misidentified as white (70%), Hispanic (16%), black (11%), and Asian/Pacific Islander (2%); for 0.9%, race was unspecified. Logistic regression results (data from all areas, all variables) indicated that urban residence at time of diagnosis, degree of AI/AN ancestry, and mode of exposure to HIV were significantly associated with racial misidentification of AI/AN people reported to HARS.

Conclusions: Our findings add to the evidence that racial misidentification of AI/AN in surveillance data can result in underestimation of AI/AN HIV/AIDS case counts. Racial misidentification must be addressed to ensure that HIV/ AIDS surveillance data can be used as the basis for equitable resource allocation decisions, and to inform and mobilize public health action.

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Figures

Figure 1
Figure 1
Combined results from linkage of HARS records of five U.S. states and one urban health jurisdiction with records of the IHS NPIRS, 1984–2002
Figure 2
Figure 2
Distribution of misidentified AI/AN people (n=459) reported to HARS by incorrectly assigned racial/ethnic classification—combined data for five U.S. states and one urban health jurisdiction, 1984–2002—results from linkage with the IHS NPIRS
Figure 3
Figure 3
Percentage distribution of AI/AN people reported to HARS by assigned race/ethnicity and site, five U.S. states and one urban health jurisdiction, 1984–2002—results from linkage with the IHS NPIRS
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References

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