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Key Indian Health Issues: STD/HIV
Sexually transmitted diseases (STDs) occur in epidemic proportions in the United States, and the burden of disease is disproportionately high among minority race groups. In 2009, American Indians were just over four times more likely than Whites to get chlamydia or gonorrhea. Gonorrhea and syphilis rates among AI/ANs have been decreasing over the past few years in fact gonorrhea is at the lowest rate ever recorded. In 2004 AI/ANs were twice as likely to contract syphilis as Whites but the 2009 data shows that both populations have almost the same rate of contracting syphilis. These infections compromise not only individual well being, but the well being of the community as a whole. Testing and treatment are the keys to reducing disease and long term consequences of undiagnosed STDs. Increased STD screening and targeted awareness efforts are essential to build on current progress and reduce disparities.
While substantial progress has been made in preventing and treating certain STDs, experts estimate that 19 million infections occur each year in the United States. In addition to the physical and psychological consequences, these diseases also take a tremendous toll on the Indian healthcare system. Nationally, direct medical costs associated with STDs are estimated at $13 billion annually.
STDs interact with reproductive health on a variety of levels:
- High rates of sexually transmitted diseases indicate high-risk behavior and vulnerability to HIV. People infected with an STD are 2 to 5 times more likely to become infected with HIV.
- Women are more likely than men to contract genital herpes, HIV, chlamydia, or gonorrhea. Women are biologically more susceptible than men to becoming infected if exposed to an STD, and STDs are more likely to remain undetected in women, resulting in delayed diagnosis and treatment.
- The impact of STDs on teens is particularly notable. About two-thirds of new cases occur among 15-24-year-olds. By age 24, at least one in three sexually active people have had an STD. Teenage girls are especially vulnerable to STDs, which can more easily infect the immature cervix.
- Untreated STDs can cause severe health consequences for women, including pelvic inflammatory disease (PID), ectopic pregnancy, and infertility. Up to 40% of females with untreated Chlamydia infections develop PID, and 20% of those may become infertile.
Because of factors such as rural geography, early sexual debut, close-knit sexual networks, and high rates of hepatitis C, substance use, and STDs, many experts now believe that HIV/AIDS is a “time bomb” that may reach epidemic proportions among Native communities. The number of American Indians and Alaska Natives diagnosed with AIDS has grown more rapidly than in any other ethnic group, increasing almost 800% from 1990 to 1999.
In response, Tribes in Oregon, Washington, and Idaho have joined together to address this common concern by forming the Red Talon STD/HIV Coalition. The Coalition merged to create the Native Adolescent Health Alliance in late 2009. The Alliance meets quarterly to share wisdom, data, and resources, identify and address common priorities, and develop strategies to eliminate STD-related disparities in addition to the prevention of suicide, drug, and alcohol use.
Visit Project Red Talon for more information and to obtain STD/HIV rates and trends among AI/ANs in the Pacific Northwest.
Sexually Transmitted Diseases Surveillance 2009 has been published and is available at http://www.cdc.gov/std/stats09/default.htm