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HIV, Chlamydia, Gonorrhea, and Primary and Secondary Syphilis among American Indians and Alaska Natives Within Indian Health Service Areas in the United States, 2007–2010

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Abstract

National rates from human immunodeficiency virus (HIV) and sexually transmitted disease (STD) surveillance may not effectively convey the impact of HIV and STDs on American Indian/Alaska Native (AI/AN) communities. Instead, we compared average annual diagnosis rates per 100,000 population of HIV, chlamydia (CT), gonorrhea (GC), and primary and secondary (P&S) syphilis, from 2007 to 2010, among AI/AN aged ≥13 years residing in 625 counties in the 12 Indian Health Service Areas, all AI/AN, and all races/ethnicities to address this gap. AI/AN comprised persons reported as AI/AN only, with or without Hispanic ethnicity. Out of 12 IHS Areas, 10 had higher case rates for CT, 3 for GC, and 4 for P&S syphilis compared to rates for all races/ethnicities. Eight Areas had higher HIV diagnosis rates than for all AI/AN, but HIV rates for all IHS Areas were lower than national rates for all races/ethnicities. Two IHS Areas ranking highest in rates of CT and GC and four Areas with highest P&S syphilis also had high HIV rates. STD and HIV rates among AI/AN were greater in certain IHS Areas than expected from observing national rates for AI/AN. Integrated surveillance of overlapping trends in STDs and HIV may be useful in guiding prevention efforts for AI/AN populations.

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Acknowledgments

The authors acknowledge Brigg A. Reilley, MPH, contractor in the National HIV/AIDS Program, Indian Health Service, Albuquerque, New Mexico, for his contributions to this article. We also thank Jimmy Braxton, AA, AS, ABC, Statistical and Data Management Branch, Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention and Neeraja Saduvala, MS, of ICF International for their contribution of data analyses for this article. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention (CDC).

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Authors and Affiliations

  1. Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA

    Frances J. Walker, Jeanne Bertolli & H. Irene Hall

  2. Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS E-02, Atlanta, GA, 30333, USA

    Eloisa Llata, Melanie M. Taylor & Hillard S. Weinstock

  3. ICF International, Atlanta, GA, USA

    Mona Doshani

  4. National STD Program, Indian Health Service, Albuquerque, NM, USA

    Melanie M. Taylor

  5. Arizona Department of Health Services, Phoenix, AZ, USA

    Melanie M. Taylor

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  1. Frances J. Walker
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Correspondence to Eloisa Llata.

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Walker, F.J., Llata, E., Doshani, M. et al. HIV, Chlamydia, Gonorrhea, and Primary and Secondary Syphilis among American Indians and Alaska Natives Within Indian Health Service Areas in the United States, 2007–2010. J Community Health 40, 484–492 (2015). https://doi.org/10.1007/s10900-014-9961-4

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  • DOI: https://doi.org/10.1007/s10900-014-9961-4

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