STIs and HIV among Northern Plains Native Americans
If you think that STIs and HIV/AIDS are endemic only to large urban centers, think again. In the mostly rural, central U.S., the American Indian people of the Northern Plains suffer from rates of STIs that, with few exceptions, are higher than any other race or ethnic group in the U.S. American Indians living within the four states of North Dakota, South Dakota, Nebraska and Iowa have higher rates of STIs and HIV/AIDS than their Native counterparts who live in other regions of the country. National data are also now beginning to show a troubling trend toward an increase in the number of new infections of HIV in tribal communities at a time when other minority groups are reporting declines in new cases. Despite the fact that regional trends reflect rates of STIs and HIV that are many times over what is found in the surrounding population, little is known about why STIs are among the greatest health disparities in Indian country.
The Northern Plains Tribal Epidemiology Center, based in Rapid City, S.D., has taken on the challenge of trying to better understand the reasons that tribal communities in South Dakota are shouldering the greatest burden for this increase in STIs and HIV throughout the region. As an epidemiologist, I am leading this project as part of the broader mission of a tribally operated program that aims to improve the health and well-being of the 18 tribal nations and communities of the Northern Plains. The Accessing STI/HIV Services Survey (ASHSS), a three-year community-based needs assessment, is the first study of its kind. The project, which is jointly funded by the South Dakota Department of Health and the Indian Health Service, has just gotten underway and will be administered in partnership with the nine tribes and four urban Indian Health Centers in South Dakota. Taking the time to build trust and establish credibility with stakeholders is the key to success for working in Indian country. It is our hope that by bringing attention to this important public health concern, more resources will become available in the future for much-needed STI and HIV prevention programs and services in tribal communities. Of course, the ultimate goal of our work is to produce actionable information that will directly benefit the American Indian people.
Corey Smith is an epidemiologist and health informatics specialist who joined the Northern Plains Tribal Epidemiology Center a little over a year ago. The Center is a 501c(3) tribally operated program that works in partnership with other agencies and organizations to improve the health and well-being of the 18 sovereign Indian nations of the Northern Plains.
