America/North Italy is a yaoi pairing originating from their interaction in one of the episodes, where America tells Italy that someone told him that he should try to go read the atmosphere. He asks if Italy knows a bookstore selling how to read the atmosphere. Italy responds with "I've been told that before, too. Let's go look for it together!"

They interact in the anime one other time, when Italy keeps getting captured by the Allies. America was the first to capture North Italy, and after a while, saying that he was "such a pain". However, they sent Italy back to Germany.

The fanmade game HetaQuest's main characters are America and North Italy, who are both searching on how to read the atmosphere in the beginning of the game.