Native Sun News: HIV cases increase within Navajo Nation

Monday, February 27, 2012  

The following story was written and reported by Kate Saltzstein, Native Sun News Correspondent. All content © Native Sun News.

NAVAJO NATION –– While the rest of the country has seen a decline in the number of AIDS cases, there has been an increase on the Navajo Nation in recent years. In fact, health providers report about 40 new cases in 2010, doubling the number recorded in recent years.

There are many reasons for this increase.

Health providers say that there’s a lack of education about the disease on the Navajo reservation and on many reservations across the country.

And the disease, which once only primarily affected people in urban areas, has spread to rural communities across the country.

Also once considered a disease of homosexual men, new cases of AIDS now appear in heterosexual men and women.

“AIDS was once a big city disease, not of rural America. But there’s been a shift. It’s spread in rural areas and border towns close to the Navajo Nation. It’s a pattern throughout rural America now. There’s more transmission in local communities,” said Dr. Jon Iralu, an Infectious Disease Specialist with the Gallup New Mexico Indian Medical Center.

So doctors and other health care professionals are focusing on testing, treatment and educating people about the disease.

In 2006 the Center for Disease Control recommended that every American between the ages of 13 and 64 get an HIV test, Iralu said. HIV is the virus that can develop into AIDS.

“We took that seriously. More people are coming in to be tested,” he said. “One explanation for the increase (in numbers of AIDS patients) is we’re looking harder for it.”

The Navajo AIDS Network, a local nonprofit agency, has created ads in the Navajo language that are now playing on the radio and in movie theaters. Billboards and buses on the reservation and in border towns carry information about AIDS and its treatment.

“These ads are in the Navajo language with flute music. There’s more screening, more testing,” said Iralu.

The good news is that the disease is treatable with the right combination of drugs.

“HIV can be treated with medication. It’s no longer immediately fatal. People can live for decades if they take their medication,” Iralu said. “It’s not a terminal illness. It’s a treatable disease. HIV doesn’t always lead to AIDs if the patient is tested and treated early. If a patient is HIV positive with the virus, medication can suppress it and it will never progress to AIDS. People can live a long time without (the HIV virus) going to AIDS.”

Iralu works with other doctors, nurses, pharmacists, a dietitian, a nurse and a psychologist to combat HIV and AIDS. And they plan to hire health technicians to do home visits and to include medicine men in their treatment program. Similar programs are happening on other reservations, he noted.

However, there are some road blocks to educating people on the Navajo reservation where “people don’t like to talk about negative things,” he said.

Melvin Harrison, a Navajo and the director of the Navajo Aids Network, works with a staff of seven to help AIDS patients.

“We make sure they go to hospitals, keep appointments, anything to plug them into services. We find good housing and transportation for them if needed,” Harrison said.

They also go to high schools, colleges and churches to educate people about the disease.

“The main reason for the increase in AIDS is Navajos are infecting Navajos. Before, in years past, people were getting infected in big cities. Now it’s on the reservation. A lot of people are going off the reservation. They travel around. People are getting infected out there, coming back home and spreading it. They work off-reservation and go to school, they follow the circuit, move back and forth,” said Harrison.

“With any infectious disease, that is typical. A new strand of disease comes across the country. It doesn’t get to Native communities right away. It takes more time.”

Doubling the number of cases on the reservation while figures show a decline in the rest of the country is troublesome, said Harrison.

At first, 40 new cases doesn’t sound like a lot, but per capita, it’s way too many, he said.

“That’s high for us. It’s really hitting us bad. That’s a 100 percent increase. In my opinion, if there was a 100 percent increase in any other community, people would be jumping up and down (with anger). That isn’t happening here. I don’t know why.”

Another trend he has noticed on the reservation is that the virus is spreading more and more to women.

“In 2010, 95 percent (of new HIV cases) were among (heterosexual men and women). Now women are getting it (more often). That’s happening nationally,” Harrison said.

A major problem combating the disease on the reservation is that people don’t like to talk about homosexuality or about death, he said.

“The biggest problem is talking about homosexuality. We don’t talk about sex on the reservation. It’s a taboo subject. But we have to talk about it.”

And, he added, “The foremost issue in Navajo and other places is the stigma of AIDS. These communities are very small. People don’t want to talk about sex, death or homosexuality. It’s very taboo. For those living with HIV, it’s very difficult to tell their loved ones; a large percentage don’t tell their loved ones.”

Another problem is fear that if you talk about a problem, it will affect you.

“People think if you talk about something you are wishing it on people. My grandmother told me not to buy health insurance or you’re wishing (bad health) on yourself. And we don’t talk about death,” said Harrison. “I know it’s uncomfortable, but we have to talk about it. Some people still think AIDS is a gay man’s disease. There’s a fear of rejection. We do workshops about how to work with Native transgender and gay people.”

People infected with HIV will tell health care providers but not their loved ones. Even now, when his team goes to a high school to educate teens about HIV, many think it’s a gay man’s disease, Harrison said, and there are no support groups for gay men and women.

Harrison and his staff also educate traditional Navajo medicine men because many Navajos go to see medicine men for help.

“Most clients don’t tell the medicine man what they have. They tell them their symptoms, and that’s what they treat. A lot of elderly people aren’t sure what the disease is.”

Money to support his program comes from the New Mexico Department of Health, the federal government and from foundations. Tribal funding has also been promised. Harrison thinks that alcohol plays a big part in the spread of AIDS.

“Some people have been rejected because they are gay or transgender. They turn to alcohol or drugs. Alcohol is a major factor. Forty percent of people with AIDS have abused alcohol or drugs. It lowers inhibitions. Having sex without a condom is a big factor. People lose their inhibitions. It’s all about sex and many are drinking and drugging. Navajo (Nation) is dry but there are bootleggers and poverty is rampant, unemployment is around 55 percent. Poverty, alcohol abuse, depression are all part of it.”

Harrison attends national conferences on AIDS education and works with a national Native HIV/AIDs coalition, which he describes as “an advocacy group with members from across the country, Hawaii to Alaska.” They work to get funding and share information about treating the disease.

(Kate Saltzstein can be reached at salty223@aol.com)