Sunday, March 20, marks National Native HIV/AIDS Awareness Day (NNHAAD) 2022. Held each year on the first day of spring, NNHAAAD presents opportunities to highlight the impact of HIV on Native communities, including American Indians, Alaska Natives, American Indians and Native Hawaiians, and to encourage HIV testing, prevention, education and care. This year’s theme is “Reflection. Celebration. Rejuvenation.”

Search the hashtag #NNHAAD for find numerous events, articles and videos planned around the awareness day, such as this interview on

The Q Austin, a “fun, weird and safe space for Austin’s LGBTQIA community” in Texas held a Facebook Live discussion March 18 with two-spirit drag king Papi Churro in honor of NNHAAD. You can watch the event here and below:

To help raise HIV awareness this year, the National Native HIV Network is hosting a #NNHAAD 22-mile virtual challenge from March 20 to April 22. Participants have a month to log their miles and can accomplish this through walking, running, canoeing, biking or other physical activities. It’s a free event, and anyone can take part; the first 500 to complete their miles will receive a medal and a T-shirt. You can register at

In 2018, American Indian/Alaska Native (AI/AN) people represented 1.3% of the U.S. population and 1% of the estimated 36,400 new HIV cases that year. This translates to 240 people in 2018, an increase from 140 in 2014, according to the Centers for Disease Control and Prevention (CDC)., which maps HIV data and presents sharable graphics, points out that gay and bisexual men represented 82% of new HIV diagnoses among AI/AN men in 2020. In the same year, injection drug use accounted for 43% of new HIV diagnoses among AI/AN women.

What’s more, points out that it’s “important to recognize how social determinants of health can negatively impact HIV-related health outcomes for Native communities due to a lack of access to affordable health care and financial insecurity. For example:

  • In 2019, 6.1% of the AI/AN population were unemployed, compared with 3.7% of the U.S. population.

  • In the same year, 15% of the AI/AN population were uninsured, compared with 8% of the U.S. population.

The five states with the highest number of new HIV diagnoses among AI/AN people in 2020 were Arizona, New Mexico, Oklahoma, Alaska and Minnesota. Together, those sates made up 54% of new HIV cases among the AI/AN population.

The CDC underscores the main challenges in preventing HIV among AI/AN people, writing:

There are more than 574 federally recognized AI/AN tribes and many different languages. Because each tribe has its own culture, beliefs and practices, creating culturally appropriate prevention programs for each group can be challenging. Additionally, racial misidentification of AI/AN people may lead to the undercounting of this population in HIV surveillance systems and may contribute to the underfunding of targeted services for AI/AN people.

Some AI/AN people experience social, cultural and economic barriers such as stigma, confidentiality concerns and poverty. These issues could limit opportunities for HIV testing, treatment and other prevention services, especially among AI/AN people who live in rural communities or on reservations. Addressing these barriers and encouraging supportive communities can help improve health outcomes for AI/AN people.

Other factors that can increase the chances of getting or transmitting HIV include:

Sexually transmitted infections (STIs). In 2018, AI/AN people had the second highest rates of chlamydia and gonorrhea among all racial/ethnic groups. Having another STD increases a person’s risk for getting or transmitting HIV.


Knowledge of HIV status. It is important for everyone to know their HIV status. People who do not know they have HIV can’t take advantage of HIV care and treatment and may unknowingly pass HIV to others.

Alcohol and illicit drug use. Alcohol and substance use can impair judgment and lead to behaviors that increase the risk of HIV. Injection drug use can directly increase the risk of HIV if a person shares needles, syringes and other drug injection equipment—for example, cookers—with someone who has the virus. Compared with other racial/ethnic groups, AI/AN people tend to use alcohol and drugs at a younger age and use them more often and in higher quantities.

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Why mark the Native HIV awareness day on the first day of spring? As the event’s founders explain on, “This day was chosen by individuals in the community who had participated in a national survey to determine what day would be most appropriate. It was acknowledged that in many Native cultures across the United States, the four seasons are highly respected because they closely represent the cycle of life. Spring also represents a time of equality and balance and is the only day when day and night are at equal lengths. It is considered a time of profound change, new beginnings and birth: a celebration of life for all people.”

To learn more about other HIV awareness days, including a calendar you can download and print, visit “2022 HIV/AIDS Awareness Days.”