title: Sexually transmitted diseases among American Indians in Arizona: an important public health disparity.
abstract: OBJECTIVE
  We conducted an analysis of rates, geographic distribution, and time to treatment of chlamydia, gonorrhea, and early syphilis (ES) among Arizona American Indians (AIs) to address racial disparities affecting this group.
  
  
  METHODS
  We used the Arizona Department of Health Services' sexually transmitted disease (STD) surveillance database to identify STD cases and calculate rates among AIs in Arizona from 2003 to 2007. We mapped AI ES cases reported during that time frame by reported resident ZIP code, calculated days elapsed from specimen collection to initial treatment, and compared rates and time to treatment for AIs with those of non-Hispanic white (NHW) individuals.
  
  
  RESULTS
  Annual Arizona AI STD rates for chlamydia, gonorrhea, and ES from 2003 to 2007 ranged from 2.7 to 7.8 times those of NHW people. During the same time period, the annual rates for all three STDs among adolescents aged 15 to 19 years were also higher among AIs and ranged from 2.0 to 14.8 times those of NHW individuals. The majority of cases for ES reported ZIP codes located in the northeastern and southern central portions of the state. The median time to treatment in AI populations was significantly longer than in NHW populations for chlamydia and gonorrhea, but not for ES.
  
  
  CONCLUSIONS
  High rates of STDs have been identified among AIs in certain regions of Arizona. Additionally, there are significant delays in treatment for gonorrhea and chlamydia. STD prevention and education programs that prioritize this health disparity and promote expeditious screening, diagnosis, and treatment are needed.
authors.affiliation: Arizona Department of Health Services, Office of HIV, STD, and Hepatitis Services, 150 N. 18th Ave., Ste. 140, Phoenix, AZ 85007-3237, USA. winscom@azdhs.gov
authors.forename: Michelle
authors.initials: M
authors.lastname: Winscott
authors.forename: Melanie
authors.initials: M
authors.lastname: Taylor
authors.forename: Kerry
authors.initials: K
authors.lastname: Kenney
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001130:Arizona / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007198:Indians, North American; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D017678:Sex Distribution; D015231:Sexually Transmitted Diseases, Bacterial / Q000208:ethnology*; D055815:Young Adult