Volume 5, No. 7, August 2007
Abstract of the Month
Within the Hidden Epidemic: Sexually Transmitted Diseases and HIV/AIDS Among American Indians and Alaska Natives.
OBJECTIVES: To review the epidemiology, research, and prevention programs for sexually transmitted diseases in American Indians and Alaska Natives (AI/ANs).
STUDY DESIGN: We reviewed the current national and regional trends in sexually transmitted diseases (STDs) for AI/ANs from 1998-2004, peer-reviewed studies from January 1996, through May 2006, and reports, unpublished documents, and electronic resources addressing AI/AN STD prevention and control.
RESULTS: STD prevalence among AI/ANs remains high. For example, the case rate of C. trachomatis in the North Central Plains AI/AN populations is 6 times the overall US rate. Trends for C. trachomatis also show sustained increases. Little research exists on STDs for this population, and most is focused on HIV/AIDS. Fear of compromised confidentiality, cultural taboos, and complex financial and service relationships inhibit effective surveillance, prevention, and management.
CONCLUSIONS: Recommendations for STD control in this population include improved local surveillance and incorporation of existing frameworks of health and healing into prevention and intervention efforts. Research defining the parameters of cultural context and social epidemiology of STDs is necessary.
Kaufman CE , Shelby L , Mosure DJ , Marrazzo J , Wong D , de Ravello L , Rushing SC , Warren-Mears V , Neel L , Jumping Eagle S , Tulloch S , Romero F , Patrick S , Cheek JE ; for the Task force on STD Prevention and Control Among American Indians and Alaska Natives .
Within the Hidden Epidemic: Sexually Transmitted Diseases and HIV/AIDS Among
American Indians and Alaska Natives. Sex Transm Dis. 2007 May 25;
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17538516
OB/GYN CCC Editorial comment:
Other AI/AN specific HIV resources:
The need for historically grounded HIV/AIDS prevention research among Native Americans
This is a brief report that summarizes the need for historically grounded HIV prevention research among Native Americans living in the United States. It illustrates the intersection of culture and history, showing that ethnic groups can respond to historical traumatic events for generations, often to the detriment of individual and collective health. Journal of the Association of Nurses in AIDS Care. 18(2):15-7, 2007 Mar-Apr.
American Indian Women, HIV/AIDS, and Health Disparity
Data are presented regarding the prevalence of HIV/AIDS among American Indian women. Health disparities found among American Indians are discussed and biological, economic, social, and behavioral risk factors associated with HIV are detailed. Recommendations are suggested to alleviate the spread of HIV among American Indian women and, in the process, to diminish a culture of treatment malpractice and a weakening of treatment ethics, racism, and genderism.
Substance Use & Misuse, Volume 42 Issue 4 2007 p. 741 - 752
The IHS National STD Program: A great resource
You will recognize many of the author’s names in the abstract above from the IHS Division of Epidemiology and Disease Prevention and the IHS National STD Program. Don’t hesitate to utilize the expertise the IHS National STD Program has to offer on HIV prevention and control. Below is some background on the IHS National STD Program.
National IHS HIV/AIDS Consultant
Scott Giberson is another great resource. Scott is the National IHS HIV/AIDS Consultant in the Office of Clinical and Preventive Services, HQE and a regular contributor to the CCCC. Scott.Giberson@ihs.gov
Background
IHS National STD Program MISSION / GOALS
The mission of the IHS National STD Program, in partnership with American Indian/Alaska
Native people, is to raise their physical, mental, social, and spiritual health
to the highest level possible through prevention and reduction of sexually transmitted
diseases.
Our goals are to:
- Raise awareness of STDs as a high priority health issue.
- Support partnerships and collaborations with state STD programs, IHS, tribal, urban Indian (I/T/U), and other public health agencies.
- Support improvement of I/T/U, state, and local STD programs for AI/AN.
- Increase access to up-to-date STD training for clinicians and public health practitioners.
- Support and strengthen surveillance systems to monitor STD trends.
- Promote STD research and identify effective interventions for reducing STD morbidity.
- Support STD outbreak response efforts.
- Support integration of STD/HIV/AIDS, and hepatitis prevention and control activities.
ABOUT US: IHS National STD Program
Sexually transmitted diseases (STDs) are a significant public health problem
in the United States and remain largely unrecognized as a serious public health
threat. Each year there are an estimated 19 million new STD infections. STDs
cause harmful and often irreversible complications, including chronic pelvic
pain, infertility, cancer, poor pregnancy and fetal outcomes, and even death.
They are also expensive to society as a whole, with direct medical costs as high
as $15.5 billion in a single year.
Although widespread across the U.S. in all populations, the STD epidemic disproportionately
affects certain racial and ethnic groups. Such disparities in STD rates are complex
to understand, but may be rooted in a number of social factors such as poverty,
inadequate access to health care, lack of education, social inequality, and cultural
influences. One group adversely affected by STDs is the American Indian and Alaskan
Native (AI/AN) population.
Since 1994, CDC has collaborated with the IHS Division of Epidemiology and Disease
Prevention by providing staff, funds, and technical assistance to address the
STD prevention needs of AI/AN. This relationship has been and continues to be
critical for the development of STD prevention capacity in Indian Country. In
recent years, the staff and budget of the IHS National STD Program have grown
dramatically. Today, the program is staffed by three CDC assignees, one IHS administrative
staff, and two contractors.
STAFF: IHS National STD Program
Scott Tulloch
Scott Tulloch is a Public Health Advisor with the CDC assigned to the IHS National
STD Program since March 2006. Scott has a variety of public health interests
including interventions in corrections, outbreak response, and community capacity
building. scott.tulloch@ihs.gov
Lori
de Ravello, MPH
Lori de Ravello is a Public Health Advisor with CDC assigned to the IHS National
STD Program. Lori is a regular contributor to the CCCC’s STD Corner lori.deravello@ihs.gov
IHS National STD Program
http://www.ihs.gov/medicalprograms/epi/index.cfm?module=health_issues&option=std&cat=sub_0
IHS Division of Epidemiology and Disease Prevention
http://www.ihs.gov/medicalprograms/epi/index.cfm
References:
American Indian Women, HIV/AIDS, and Health Disparity
Vernon IS. American Indian Women, HIV/AIDS, and Health
Disparity Substance Use & Misuse, Volume 42 Issue 4 2007 p. 741
- 752
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17558961
The need for historically grounded HIV/AIDS prevention research among Native Americans
Lowe J Research brief: the need for historically grounded HIV/AIDS prevention research among Native Americans. [Review] Journal of the Association of Nurses in AIDS Care. 18(2):15-7, 2007 Mar-Apr. http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17403492
Contents Summary ‹ Previous | Next › From Your Colleagues
OB/GYN
Dr. Neil Murphy is the Obstetrics and Gynecology Chief Clinical Consultant (OB/GYN C.C.C.). Dr. Murphy is very interested in establishing a dialogue and/or networking with anyone involved in women's health or maternal child health, especially as it applies to Native or indigenous peoples around the world. Please don't hesitate to contact him by e-mail or phone at 907-729-3154.
