HIV trends on the Navajo Nation

Health, Education, and Human Services Committee receives
report on recent HIV trends on the Navajo Nation
Diné people encouraged to learn more about HIV and get tested
WINDOW ROCK - The Health, Education, and Human Services Committee on August 29
received a report regarding the human immunodeficiency virus, more commonly known as
HIV, and how it is impacting the Navajo Nation.
Representatives from the Indian Health Service, the Navajo Nation Health Education
Program, and the Navajo AIDS Network briefed the committee for nearly an hour on HIV
trends and statistics on the nation. Current prevention education and outreach
efforts were also discussed.
Dr. Jonathan Iralu, chief clinical consultant for infectious diseases at Gallup
Indian Medical Center, who has been treating HIV patients in Gallup for nearly 20
years, compiles much of the data on HIV relating to Navajo patients.
According to Dr. Iralu, thirty-nine new cases of HIV were diagnosed in 2011. This is
up from the thirty-five cases that were diagnosed in 2010.
The first HIV case on the Navajo Nation was diagnosed in 1987.
Since the mid-1990's, an average of 10 new cases per year used to be diagnosed. In
the last three years, however, that statistic has quadrupled.
According to the 2011 Navajo Area IHS HIV Annual Report, the two largest risk
factors were men who have sex with men (MSM) and heterosexuals, or sex between a man
and a woman.
"People are now catching the HIV virus through heterosexual sex, something that
didn't happen ten years ago when we first started taking statistics," said Dr.
Iralu, indicating that there has been a big shift over the years from when most of
the new cases stemmed mainly from men having sex with men.
"Women now make up one-third (1/3) of the new cases diagnosed," said Dr. Iralu.
Dr. Iralu was content to report that so far there have been no babies or children
that have been diagnosed.
About half of the new cases in 2011 have been diagnosed at the Gallup Indian Medical
Center, and that is mainly attributable to the fact that practitioners there have
been testing every patient coming into the hospital who consents to an HIV test.
Although a majority of the diagnoses were made in Gallup, Dr. Iralu wants people to
understand that this is not just a "bordertown effect." New cases are being
diagnosed in other facilities across the Navajo Nation.
HIV patients are being placed on treatment, and "people who already know they have
the disease are getting excellent care, but what we're really worried about are the
patients who don't know they have the virus," said Dr. Iralu.
There is reason to believe that there is a substantial amount of people who do not
know they have HIV.
This is why getting the message out about HIV screening and testing is so important,
said Dr. Iralu.
Philene Herrera, program manager for the Navajo Nation Health Education Program,
said there are only five HIV educators that cover prevention education efforts for
the vast nation.
"Right now, we have enlisted the support of our Health Education Program educators
to support the HIV prevention staff in conducting outreach and screening," said
Herrera, who mentioned that in addition to outreach on HIV, staff also provides AIDS
education.
Staff undergoes "rigorous" training to ensure that "they are competent and can
provide HIV screening and counseling," Herrera said.
Council Delegate Joshua Lavar Butler (Tó Nanees Dizí) recommended for the committee
to place their support behind efforts to obtain a prime fair booth location for the
program at the upcoming Navajo Nation Fair to effectively promote their HIV
prevention and testing messages.
"It's important we do screening and curb the spread of this virus," said Delegate
Butler.
The Health Education program continues to work with the Dr. Iralu and the IHS, along
with the nation's program for sexually transmitted disease prevention and the
non-profit Navajo AIDS Network, to churn out HIV and STD prevention messages across
the Navajo Nation.
As an example of his outreach efforts, Larry Foster, STD program manager under the
Navajo Division of Health, said he has set up an education and outreach table
outside a popular bar in Gallup on a Monday afternoon.
Alcohol abuse has been identified as an attribute of half of the HIV cases on the
nation, says Dr. Iralu.
Regardless, HIV is a preventable illness, Dr. Iralu added.
"We believe now that if somebody has the HIV virus, you can prevent new cases by
treating that index patient. If you treat the first person, their contacts don't get
HIV," said Dr. Iralu, "The way to do this effectively is to diagnose the new cases
so we can get the treatment going really early so the virus won't really spread."
Council Delegate Jonathan Hale (Oak Springs, St. Michaels), chair of the Health,
Education, and Human Services Committee, stated, "It is important for residents on
the Navajo Nation to become educated on HIV, and take proactive steps to get
themselves tested. Taking an HIV test means that you are not only protecting your
own health, but you are also protecting the health of the nation and future
generations."