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IHS Awards Address Epidemic in Indian Country

by Andrew Yu, MS, BSN, RN, ACRN, HIV/HCV/STI Clinical Coordinator, Division of Clinical and Community Services

On World AIDS Day, recognized on December 1, the Indian Health Service is bringing attention to the current human immunodeficiency virus (HIV), hepatitis C (HCV) and sexually transmitted infection (STI) syndemic affecting many parts of Indian Country. Earlier this year, the Indian Health Service announced the availability of $2.5 million in cooperative agreements to End the HIV and HCV epidemics in Indian Country, known at IHS as the ETHIC Program. Seven tribal and urban Indian organizations received $1.2 million in funding to work towards eliminating HIV, HCV and STIs.

Here are grantee highlights framed by the EHE pillars of Diagnose, Treat, Prevent and Respond:

Seattle Indian Health Board – Seattle, Washington

SIHB will use ETHIC funding to respond to the HIV and HCV epidemics by reducing the new HIV and HCV infections in Seattle-King County’s American Indian and Alaska Native communities. Reducing infections is critical as Seattle-King County is an EHE focus jurisdiction Exit Disclaimer: You Are Leaving  and the most populous county in Washington State. The county is home to approximately 7,000 individuals living with HIV. SIHB will also implement peer HIV testing in the community so more people are aware of their HIV status. In addition, ETHIC will provide rapid linkage to care for American Indians and Alaska Natives diagnosed with HIV, HCV and STI, including treatment initiation. Finally, SIBH will hire a care coordinator to link people to prevention services, such as PrEP, and facilitate medical appointments with medication adherence.

Albuquerque Area Indian Health Board, Inc. – Albuquerque, New Mexico

ETHIC funding will serve 27 tribes in the Albuquerque area heavily impacted by HIV, HCV and STIs. Access to care, including HIV PrEP, is limited. The health board will distribute testing and safer sex supplies to tribal communities. They will also use ETHIC to certify public health staff as HIV, HCV and STI counselors/testers and conduct referral services. AAIHB will train healthcare providers on HIV PrEP implementation while honoring spiritual and cultural values. Additionally, the health board will develop regional strengths-based and trauma-informed social media marketing campaigns to raise community awareness of prevention and treatment strategies.

Southern Indian Health Council, Inc. – Alpine, California

The SIHC will expand its Roaming Outpatient Access Mobile Program, a mobile clinic providing outpatient medical, dental and behavioral health services to seven Consortium Tribal Reservations in Southern California. To increase access to care and to meet the needs of Native youth, funding will expand ROAM services by expanding hours of operation to include evenings and weekends and provide resources at youth-oriented events. Called R2R, the expansion of ROAM will include (1) a full-time licensed vocational nurse to provide free rapid testing for and counseling, (2) provide information and prescriptions for HIV PrEP and PEP, and (3) provide free human papillomavirus 9-valent vaccines. Funding will also allow the development of a Native Youth Sexual Health Advisory Board to disseminate youth-friendly sexual health messaging through social media channels.

Native American Rehabilitation Association of the Northwest – Portland, Oregon

The association will expand its HIV, HCV and STI testing by establishing a standalone STI clinic managed by a registered nurse manager. Funding will also increase their ability to provide linkage to treatment services for individuals that test positive. The STI registered nurse and project coordinator will conduct frequent educational training on HIV, HCV and STI prevention, diagnosis, and treatment across all the association’s sites. In addition, NARA NW will implement HIV PrEP and safe syringe programs and develop videos with medical providers, the Two-Spirit community, and youth for prevention and advocacy messaging.

First Nations Community HealthSource – Albuquerque, New Mexico

FNCH aims to reduce new HIV and HCV diagnosis rates by increasing prevention services, testing, and treatment available to American Indian and Alaska Native people in New Mexico. They will hire HIV specialists to conduct HIV and HCV testing with counseling services, provide prevention education, and rapidly link people to HIV, HCV and STI treatment and HIV PrEP services. First Nations will also provide case management services to newly diagnosed people living with HIV to improve retention in care and reach sustained viral suppression.

The Chickasaw Nation – Ada, Oklahoma

Chickasaw Nation will use funding to hire a full-time registered nurse program coordinator and purchase thousands of HIV screening tests and phlebotomy supplies resulting in significant increases in HIV screening. Reducing new HIV infections is critical as Oklahoma is identified as an EHE focus state Exit Disclaimer: You Are Leaving  with a substantial HIV burden in rural areas. In addition, the Chickasaw Nation will (1) develop standardized screening tools for use in non-traditional settings, (2) create awareness campaigns to help promote sexual health education and PrEP services, (3) immediately link people testing positive for HIV/HCV/STIs, (4) and train additional medical and clinical staff on HIV, HCV and STI issues.

Rosebud Sioux Tribe – Rosebud, South Dakota

RST will address the syndemic by funding a project coordinator to work with the Rosebud Sioux Tribe correctional facility and support HIV and HCV screening and care navigation. This position is vital as Todd County, South Dakota, the seat of the Rosebud Indian Reservation, has the highest HCV rate among non-urban counties in South Dakota and the fourth highest of all U.S. counties for liver-disease-related mortality. In addition, care navigation will result in a reduction of frequent delays and interruptions in treatment, leading to better medication adherence and the ability to achieve viral suppression rapidly.

Andrew Yu, MS, BSN, RN, ACRN, HIV/HCV/STI Clinical Coordinator, Division of Clinical and Community Services

Andrew Yu is the national HIV/HCV/STI clinical coordinator for the Indian Health Service Division of Clinical and Community Services. He obtained his Bachelor of Science in Nursing from Georgetown University and his Master of Science in Community and Public Health Nursing from Hunter College - CUNY. He is also certified as an AIDS care registered nurse and an active member of the Association of Nurses in AIDS Care.