title: 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.
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.
authors.affiliation: 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.
authors.forename: Frances J
authors.initials: FJ
authors.lastname: Walker
authors.forename: Eloisa
authors.initials: E
authors.lastname: Llata
authors.forename: Mona
authors.initials: M
authors.lastname: Doshani
authors.forename: Melanie M
authors.initials: MM
authors.lastname: Taylor
authors.forename: Jeanne
authors.initials: J
authors.lastname: Bertolli
authors.forename: Hillard S
authors.initials: HS
authors.lastname: Weinstock
authors.forename: H Irene
authors.initials: HI
authors.lastname: Hall
mesh_terms: D000293:Adolescent; D000328:Adult; D002487:Centers for Disease Control and Prevention, U.S.; D002690:Chlamydia Infections / Q000208:ethnology; D005260:Female; D006069:Gonorrhea / Q000208:ethnology*; D015658:HIV Infections / Q000208:ethnology; D006801:Humans; D015994:Incidence; D007198:Indians, North American / Q000706:statistics & numerical data*; D004930:Inuit / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012749:Sexually Transmitted Diseases / Q000208:ethnology*; D013587:Syphilis / Q000208:ethnology; D014481:United States / Q000453:epidemiology; D016549:United States Indian Health Service / Q000706:statistics & numerical data*; D055815:Young Adult