Native populations face AIDS threat

YUMA, Ariz. (AP) 4-07

When national AIDS experts describe how American Indians are facing another historic battle for existence, they pass up the word “epidemic” and go right for “extinction.”

These experts stress that America's first people are experiencing an alarming increase in AIDS cases, a trend that many say could wipe out whole populations if momentous action isn't taken now.

“Extinction is not an option,” said Dr. Monica Ruiz, a top figure with the American Foundation for AIDS Research (AmFAR). “This isn't about a virus. It's about human beings - families and communities - entire races of people facing a disastrous potential if we close our eyes to it.”

Arizona currently ranks 22nd in the nation in terms of AIDS overall, according to the Centers for Disease Control. But when measuring its occurrence among American Indians, that ranking rises to second in the nation.

American Indians make up less than 1 percent of the national population, but this demographic still represents the third-highest infected racial group in the nation.

According to Ruiz, 10.6 of every 100,000 American Indians are infected with AIDS. That's compared to 72.8 for blacks, 28.5 Hispanics, 9.0 Caucasians and 7.6 Asians.

Arizona's numbers for AIDS show American Indians being the fourth-hardest hit racial group, behind blacks, Caucasians and Hispanics, according to Dr. Charleton Wilson, an associate director for the Phoenix Indian Medical Center.

“The rate of AIDS for American Indians has been higher than that for whites since 1995,” Ruiz said. “This is a problem that has been in motion for a long time.”

With headquarters in New York and Washington, D.C., AmFAR is one of the world's leading nonprofit organizations dedicated to the support of AIDS research, prevention and education.

Ruiz is the foundation's acting director for public policy and is based in Washington, D.C.

According to new statistics, 61 percent of American Indians are contracting AIDS through male-to-male sexual contact, followed by intravenous drugs at 15 percent. Heterosexual contact makes up the smallest portion of infections at 10 percent.

Ruiz quickly stressed, however, that these numbers do not mean that heterosexuals are not being infected. She explained that research shows that many males will identify as not being gay, but still have same-sex encounters.

Wilson said Arizona appears to be following national trends when it comes to cases on the rise. He said that while there may simply be more cases of AIDS, the rise in numbers could also reflect a good job by the medical community in reaching out to those in need.

“The American Indian population itself is also growing quickly and the population is relatively young, too,” Wilson said.

A total of 11,614 Arizonans are infected with HIV or AIDS, according to the more current statistics from Arizona Department of Health Services. Of those cases, 418 are American Indians, a number that would include the Cocopah Tribe in Yuma County.

Numbers for Yuma's nearby Quechan Tribe would be counted in California statistics. The Sun tried to obtain numbers for the Quechan, but agencies could only provide five-year-old statistics.

The Quechan Tribe funds an HIV-AIDS awareness program, but the Cocopah Tribe does not. A spokeswoman for the latter tribe said Cocopah AIDS statistics are not available for public release.

“The tribe does not have a program specifically established to target AIDS, and all medical files and records for the tribe are kept confidential at the Fort Yuma (Indian Health Service) Hospital,” said Liz Pratt, public relations representative for the Cocopah.

“It's misleading under any circumstance to take statistical information from a large, national perspective and assume that every tribe across the country is the same and seeing the exact same trends, which isn't the case.”

Not only are American Indians tied to a deadly trend, they are also belabored with numerous social and economic challenges that Ruiz says promise to fuel the rates of AIDS deaths even more. American Indians share many of these challenges with countless other groups, but unfortunately, this group tends to suffer more than its fair share in terms of AIDS infection, according to Ruiz.

Ruiz said that while risky behavior for American Indians is no different any other group, “these behaviors often occur in environments of extreme poverty ... and coexist along other modern 'epidemics' such as alcohol and drug abuse, high sexually transmitted infection rates and gender-based violence...”

Ruiz pointed to the issue of social stigma surrounding AIDS, the fear to talk about it, get tested, and seek community support.

“The stigma is still there on this issue. In the general population, it's still there.”

Heightening the damage is that American Indians, in general, may be reluctant to trust and reach out to government-funded programs or institutions.

“These trends are complicated by the history of mistrust in our minority communities, based on their abuse by the system,” Ruiz said. “When you think about the history of American Indians in the U.S and how they have been treated by the federal government, you know there is mistrust.”

That lack of trust, she added, can be dangerous when people don't talk freely about AIDS and when they are in denial about its potential damage to their lives.

Secondly, she points to the lack of access to proper medical care and prevention information. Ruiz stressed that most American Indian reservations are in rural areas, which tends to make matter worse.

Increasing prevention education and testing programs, Ruiz said, would amount to a good start on turning around the trend in AIDS.

Ruiz added that tribes and their communities around the country are increasingly doing a better job of handling AIDS, but those efforts are just the beginning.

“There is some progress, but so much more needs to be done,” she said. “... HIV is contributing to the destruction of our First Nations peoples. We must act now. This is everyone's problem.”