By the end of 2000, 2,337 AIDS cases had been reported among American Indians and Alaska Natives (AN/AI) in the United States and its territories, about 25% increase over the number of cases reported through 1997 (CDC 2000).

Studies indicate AI/AN experience significantly higher rates of co-morbidities for HIV such as sexually transmitted infections (STI's) , mental illness (particularly depression), and chemical dependency, including alcoholism (HIS, 2000). Often these co-morbidities are linked to one another and facilitate exposure to and progression of HIV disease (HAB, 2001; Duran et al., 2000; Hesselbrock et al., 2000; Manson, 2000; Novins, et al., 2000; Chester et al., 1999; and Sullivan, 1991).

The emphasis of this initiative is to integrate an array of services for HIV positive or at risk AI/AN population with co-morbidities of substance abuse, sexually transmitted infections and/or mental illness.