This study examined the epidemiology of HIV among AI/ANs in Montana. Barriers to HIV testing and motivations to test also were explored. Analysis of data revealed that there were no significant changes in regard to HIV/AIDS case rates, demographic characteristics, or risk behaviors of AI/ANs infected with HIV/AIDS since reporting began in 1985. Barriers to testing included low perception of risk and fear of people finding out about the test. Despite major barriers to testing identified in this study, AI/ANs appeared to be testing at a higher rate than Whites.