Post by blackcrowheart on Dec 2, 2005 14:12:16 GMT -5
Officials fear high American Indian STD rates leave door open for HIV
By Natasha D. Bordeaux, Journal Staff Writer
www.rapidcityjournal.com/
High rates of reported sexually transmitted diseases in South Dakota's
American Indian population have health administrators worried about the
potential for a large HIV outbreak if the disease is introduced into
certain behavioral groups.
"All it takes is introducing someone with HIV, and we'll have a fairly
large outbreak on our hands," Sarah Patrick, a contract epidemiologist
for Indian Health Service, said.
She said the high number of sexually transmitted diseases reported in
American Indians in South Dakota is an indication of unhealthy behaviors
that are ideal for nurturing an HIV outbreak.
STDs are diagnosed in Indians in South Dakota at a rate higher than the
rest of the population, according to a South Dakota Department of Health
report.
The report indicates that in 2002, Indians had 46 percent of the
reported chlamydia cases and 48 percent of the reported gonorrhea cases
in South Dakota, even though they comprise merely 8.3 percent of South
Dakota's total population, according to the 2000 census.
The surveys reflect numbers that are reported to the Department of
Health by clinic and laboratories throughout the state.
"One of the things that concerns me with everything now is the risk
they're taking with unprotected sex. What would prevent the same group
of people from getting another kind of disease like HIV that could kill
them?" Patrick said.
Indians are already disproportionately affected by HIV/AIDS in South
Dakota, according to Department of Health statistics. Indians comprise
13 percent of all HIV/AIDS cases, with men ages 20 to 39 accounting for
the majority of those cases.
Experts fear HIV/AIDS cases could sharply increase given the right
circumstances because the behaviors associated with contracting sexually
transmitted diseases are the same ones that spread HIV.
Dave Morgan, Sexually Transmitted Disease Program manager for the
Department of Health, said the numbers give reason for alarm for the
Indian population.
"It is an area for real concern," Morgan said. "The message I'd like to
give to people is that they do need to take some precautions."
Morgan said a high-risk lifestyle is probably the main reason for the
higher numbers of Indians being diagnosed with STDs. He said such
factors as alcohol and drug use, multiple sexual partners, unprotected
sex, health-care access and economic considerations also play a part.
A small portion of the Indian STD statistics can be attributed to IHS's
strong compliance with state STD reporting standards and IHS's acute
awareness of the need for screening, he said. Even so, Morgan said the
STD problem among Indians is still considerable.
"With everything else considered, the rates are still higher in the
Native American population," Morgan said.
He said IHS reports every diagnosed STD. "With the private sector, I
can't say that it is as complete," Morgan said.
He also said IHS is funded to do chlamydia screenings and that their
staff is trained to be aware of the need for STD screenings. As a
result, Morgan said, more people in the Indian population are being
screened than in other populations.
Still, Indians are being diagnosed with STD more frequently, he said. He
compares the chlamydia diagnoses to illustrate the situation.
"At the IHS, of all the screenings, 7 to 10 percent of the population
tested are infected. At the family-planning clinics, we have a 5 percent
positivity rate."
Morgan said the problem is not racial or even cultural.
"It's more of a behavioral problem. This should not be a racial
stereotype," he said.
Patrick agrees. She said the Indians who are engaging in high-risk
behaviors are the ones who are reflected in the health-department
statistics.
Those risk factors are a high rate of sexual-partner exchange, a large
number of partners over time and not using condoms.
"I would feel comfortable saying that in the state as a whole, certain
behavior groups, certain networks, have higher rates of gonorrhea. Some
are on the reservation some are not," Morgan said.
He said such diseases as chlamydia, gonorrhea and syphilis are often
spread through certain groups of people.
"Once a disease is introduced into a social group, it tends to stay
within that group. And Native Americans have their own social group,"
Morgan said.
Patrick said the spread of STDs "is somewhat confined in area or among
sexual partners. It doesn't mean the whole community is affected, but
just those people sharing risk factors together."
Morgan said he does not believe lack of awareness about STDs or lack of
education about STD prevention are behind the statistics for Indians.
He said the education is there, "But the application to their own life
may not be there."
All 11 South Dakota IHS facilities have plans in place to address the
STD issue, according to Laverne Parker, the nurse consultant for
hospitals and clinics for the Aberdeen area IHS. She said each unit has
one person designated to undertake STD-related duties.
Arlene Marshall, Aberdeen Area Health Education consultant, said IHS in
South Dakota doesn't have a specific program related to STD prevention.
Rather, she said, "Indirectly, we have prevention and promotion, but
it's directed at healthy living."
She said IHS receives limited funding that is distributed to service
units or tribes to spend on STD and HIV prevention. There are nine
health-care educators in South Dakota, some funded through IHS and some
funded by tribes.
"Our whole goal was to make it local and make it within that community,
so they wouldn't feel like someone was coming into the community, then
leaving," Marshall said.
"I know tribes are doing a lot because they get their own grants. But
that's where the money should be - with the tribes," Marshall said.
She said that as a health-education consultant, she has made STD
public-service announcements that are culturally specific to American
Indians for use in schools.
"We've trained and require all health educators go to take at least
HIV/AIDS education. It's not just HIV/AIDS, but it is behavior
education," Marshall said.
The state of South Dakota also offers funding and prevention services
aimed to curb STD rates in Indians.
As part of its HIV-prevention planning activities, South Dakota
Department of Health has a Native American Advisory Committee, where
individuals from local communities who are interested in HIV prevention
contribute to planning efforts for HIV-prevention activities. The
committee is a requirement of an HIV-prevention grant.
As a result of those meetings, the Department of Health contracted with
the Red Cross to adapt a culturally specific curriculum toward HIV
prevention to be used in Indian communities across the state.
On one South Dakota reservation, a research team from the University of
Colorado is looking into the attitudes and behaviors toward STDs and HIV
in "a specific Northern Plains tribe" as a result of its high STD rates.
The program isn't able to release information about the research or the
subject of the research because it is ongoing.
The field office director for that program, CeCe Big Crow, works with
local health-care agencies in separate education and prevention
activities. She feels that awareness and education about STDs and HIV on
the reservation she works with are not up to par.
"It is important for our office to continue the work because of the
alarming rates of STDs and the lack of education and awareness about
STDs and HIV, like what causes it and how to better protect yourself,"
she said.
Two tribal STD/HIV-prevention programs on Rosebud Reservation are aimed
at curtailing high STD rates there.
This summer, three youths have been trained as peer counselors to other
youths on the reservation in STD-related issues. The program is funded
for only this summer through a Seva Foundation grant. Administrators
hope to make the program a year-round effort if they can obtain further
funding.
The other program on Rosebud Reservation is designed specifically for
STD and HIV prevention and education. A $5,000 IHS grant provides enough
funding to make STD and HIV information available to the public through
tribal health programs and at various health fairs.
A new program on the Cheyenne River Sioux Reservation called Cheyenne
River STD Prevention Education Program is designed to curb high rates of
STDs among adolescents and young men and women on that reservation.
Cheyenne River Reservation has had the highest rate of STDs in the state
in past years, according to Department of Health data.
The Prevention Education Youth Involvement Program sponsors the
prevention program for Volunteers of America. Linda Kingery is the
director.
She said she is designing an STD-related curriculum to possibly be used
in schools and that she will offer an STD presentation to a youth center
in Eagle Butte. She is also inviting an improvisation group from Sioux
Falls to make a presentation on STDs at a teen dance. The program was
just instituted in May.
Kingery said she believes education is an important aspect to reducing
STDs and HIV in the young men and women who are the target population
for her program. She said most of them are aware of STDs but only need
to have that information reinforced.
"I've never come across a teenager who hasn't heard about them. Most
kids think they are invincible, that it's not going to happen to them.
But it does," Kingery said.
Contact Natasha D. Bordeaux at natasha.bordeaux@rapidcityjournal.com
By Natasha D. Bordeaux, Journal Staff Writer
www.rapidcityjournal.com/
High rates of reported sexually transmitted diseases in South Dakota's
American Indian population have health administrators worried about the
potential for a large HIV outbreak if the disease is introduced into
certain behavioral groups.
"All it takes is introducing someone with HIV, and we'll have a fairly
large outbreak on our hands," Sarah Patrick, a contract epidemiologist
for Indian Health Service, said.
She said the high number of sexually transmitted diseases reported in
American Indians in South Dakota is an indication of unhealthy behaviors
that are ideal for nurturing an HIV outbreak.
STDs are diagnosed in Indians in South Dakota at a rate higher than the
rest of the population, according to a South Dakota Department of Health
report.
The report indicates that in 2002, Indians had 46 percent of the
reported chlamydia cases and 48 percent of the reported gonorrhea cases
in South Dakota, even though they comprise merely 8.3 percent of South
Dakota's total population, according to the 2000 census.
The surveys reflect numbers that are reported to the Department of
Health by clinic and laboratories throughout the state.
"One of the things that concerns me with everything now is the risk
they're taking with unprotected sex. What would prevent the same group
of people from getting another kind of disease like HIV that could kill
them?" Patrick said.
Indians are already disproportionately affected by HIV/AIDS in South
Dakota, according to Department of Health statistics. Indians comprise
13 percent of all HIV/AIDS cases, with men ages 20 to 39 accounting for
the majority of those cases.
Experts fear HIV/AIDS cases could sharply increase given the right
circumstances because the behaviors associated with contracting sexually
transmitted diseases are the same ones that spread HIV.
Dave Morgan, Sexually Transmitted Disease Program manager for the
Department of Health, said the numbers give reason for alarm for the
Indian population.
"It is an area for real concern," Morgan said. "The message I'd like to
give to people is that they do need to take some precautions."
Morgan said a high-risk lifestyle is probably the main reason for the
higher numbers of Indians being diagnosed with STDs. He said such
factors as alcohol and drug use, multiple sexual partners, unprotected
sex, health-care access and economic considerations also play a part.
A small portion of the Indian STD statistics can be attributed to IHS's
strong compliance with state STD reporting standards and IHS's acute
awareness of the need for screening, he said. Even so, Morgan said the
STD problem among Indians is still considerable.
"With everything else considered, the rates are still higher in the
Native American population," Morgan said.
He said IHS reports every diagnosed STD. "With the private sector, I
can't say that it is as complete," Morgan said.
He also said IHS is funded to do chlamydia screenings and that their
staff is trained to be aware of the need for STD screenings. As a
result, Morgan said, more people in the Indian population are being
screened than in other populations.
Still, Indians are being diagnosed with STD more frequently, he said. He
compares the chlamydia diagnoses to illustrate the situation.
"At the IHS, of all the screenings, 7 to 10 percent of the population
tested are infected. At the family-planning clinics, we have a 5 percent
positivity rate."
Morgan said the problem is not racial or even cultural.
"It's more of a behavioral problem. This should not be a racial
stereotype," he said.
Patrick agrees. She said the Indians who are engaging in high-risk
behaviors are the ones who are reflected in the health-department
statistics.
Those risk factors are a high rate of sexual-partner exchange, a large
number of partners over time and not using condoms.
"I would feel comfortable saying that in the state as a whole, certain
behavior groups, certain networks, have higher rates of gonorrhea. Some
are on the reservation some are not," Morgan said.
He said such diseases as chlamydia, gonorrhea and syphilis are often
spread through certain groups of people.
"Once a disease is introduced into a social group, it tends to stay
within that group. And Native Americans have their own social group,"
Morgan said.
Patrick said the spread of STDs "is somewhat confined in area or among
sexual partners. It doesn't mean the whole community is affected, but
just those people sharing risk factors together."
Morgan said he does not believe lack of awareness about STDs or lack of
education about STD prevention are behind the statistics for Indians.
He said the education is there, "But the application to their own life
may not be there."
All 11 South Dakota IHS facilities have plans in place to address the
STD issue, according to Laverne Parker, the nurse consultant for
hospitals and clinics for the Aberdeen area IHS. She said each unit has
one person designated to undertake STD-related duties.
Arlene Marshall, Aberdeen Area Health Education consultant, said IHS in
South Dakota doesn't have a specific program related to STD prevention.
Rather, she said, "Indirectly, we have prevention and promotion, but
it's directed at healthy living."
She said IHS receives limited funding that is distributed to service
units or tribes to spend on STD and HIV prevention. There are nine
health-care educators in South Dakota, some funded through IHS and some
funded by tribes.
"Our whole goal was to make it local and make it within that community,
so they wouldn't feel like someone was coming into the community, then
leaving," Marshall said.
"I know tribes are doing a lot because they get their own grants. But
that's where the money should be - with the tribes," Marshall said.
She said that as a health-education consultant, she has made STD
public-service announcements that are culturally specific to American
Indians for use in schools.
"We've trained and require all health educators go to take at least
HIV/AIDS education. It's not just HIV/AIDS, but it is behavior
education," Marshall said.
The state of South Dakota also offers funding and prevention services
aimed to curb STD rates in Indians.
As part of its HIV-prevention planning activities, South Dakota
Department of Health has a Native American Advisory Committee, where
individuals from local communities who are interested in HIV prevention
contribute to planning efforts for HIV-prevention activities. The
committee is a requirement of an HIV-prevention grant.
As a result of those meetings, the Department of Health contracted with
the Red Cross to adapt a culturally specific curriculum toward HIV
prevention to be used in Indian communities across the state.
On one South Dakota reservation, a research team from the University of
Colorado is looking into the attitudes and behaviors toward STDs and HIV
in "a specific Northern Plains tribe" as a result of its high STD rates.
The program isn't able to release information about the research or the
subject of the research because it is ongoing.
The field office director for that program, CeCe Big Crow, works with
local health-care agencies in separate education and prevention
activities. She feels that awareness and education about STDs and HIV on
the reservation she works with are not up to par.
"It is important for our office to continue the work because of the
alarming rates of STDs and the lack of education and awareness about
STDs and HIV, like what causes it and how to better protect yourself,"
she said.
Two tribal STD/HIV-prevention programs on Rosebud Reservation are aimed
at curtailing high STD rates there.
This summer, three youths have been trained as peer counselors to other
youths on the reservation in STD-related issues. The program is funded
for only this summer through a Seva Foundation grant. Administrators
hope to make the program a year-round effort if they can obtain further
funding.
The other program on Rosebud Reservation is designed specifically for
STD and HIV prevention and education. A $5,000 IHS grant provides enough
funding to make STD and HIV information available to the public through
tribal health programs and at various health fairs.
A new program on the Cheyenne River Sioux Reservation called Cheyenne
River STD Prevention Education Program is designed to curb high rates of
STDs among adolescents and young men and women on that reservation.
Cheyenne River Reservation has had the highest rate of STDs in the state
in past years, according to Department of Health data.
The Prevention Education Youth Involvement Program sponsors the
prevention program for Volunteers of America. Linda Kingery is the
director.
She said she is designing an STD-related curriculum to possibly be used
in schools and that she will offer an STD presentation to a youth center
in Eagle Butte. She is also inviting an improvisation group from Sioux
Falls to make a presentation on STDs at a teen dance. The program was
just instituted in May.
Kingery said she believes education is an important aspect to reducing
STDs and HIV in the young men and women who are the target population
for her program. She said most of them are aware of STDs but only need
to have that information reinforced.
"I've never come across a teenager who hasn't heard about them. Most
kids think they are invincible, that it's not going to happen to them.
But it does," Kingery said.
Contact Natasha D. Bordeaux at natasha.bordeaux@rapidcityjournal.com