“A Tricky Dance”: Ryan White Service Experiences Among American Indian/Alaska Native Two-Spirit and LGBTQ + People Living with HIV

Advancements in HIV treatment and care have led to a growing number of American Indian and Alaska Native (AI/AN) Two-Spirit and LGBTQ + (2S/LGBTQ +) people living with HIV. However, their experiences within the Ryan White HIV/AIDS Program (RWHAP) remain underexplored. In this brief report, we conducted a secondary qualitative analysis using reflexive thematic analysis of 15 in-depth interviews with AI/AN 2S/LGBTQ + people living with HIV. Findings revealed that many RWHAP recipients became HIV advocates, contributing to healthy aging. Participants highlighted the effectiveness of the RWHAP in addressing immediate needs, while also emphasizing the need for greater representation and culturally congruent care. Future research should focus on exploring culturally congruent care services for AI/AN 2S/LGBTQ + individuals, particularly for those aging with HIV.