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6 Indeed, 5 of the top 10 leading causes of death for American Indian men (i.e., unintentional injuries, chronic liver disease and cirrhosis, diabetes mellitus, suicide, and homicide) are related to voluntary risky behaviors such as alcohol abuse, and might be preventable with appropriate public health intervention. 5 Additionally, life expectancy for American Indian men is significantly shorter than for White men or American Indian women, with early death caused in part by disproportionate rates of homicide, suicide, and motor vehicle accidents. Data from the only 2 comprehensive reviews of American Indian men’s health indicate that they suffer from disproportionate rates of poor health compared with men in the general population. 2, 3Īlthough preliminary evidence suggests that American Indian men might respond differently than American Indian women to the history of indigenous oppression, 4 there is little empirical research on the health status of American Indian men. Two-spirit men are a vulnerable population whose victimization must be understood within an appropriate historical and political context.Īmerican Indians and Alaska Natives are a people under siege, living within a colonial nation-state in a “fourth world.” 1 This “indigenist” perspective foregrounds their historical and political context, including their experience of a succession of traumatic assaults, and is essential to contexualizing their current health status. The percentage of HIV infection was surprisingly high (10% of two-spirit men and 6% of heterosexual men).Ĭonclusions. Overall, victimization was associated with lifetime HIV risk behaviors (even after control for sexual orientation) but not with substance use or unsafe sex in the past 12 months. The 20 men self-identifying as gay, two-spirit, or bisexual (hereafter, “two-spirit”) were more likely to report being victimized and engaging in HIV risk behaviors than the 51 heterosexual respondents, although they reported comparable levels of recent substance use.
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A survey was mailed to all members of an American Indian community organization in New York City. condary aims included describing condom-use attitudes, beliefs about HIV/AIDS in the Indian community, HIV knowledge, HIV status, and preference for and access to HIV prevention services in this population.