Guest Commentary<br>Surgeon General calls for action on HIV/AIDS Crisis

The endurance and perseverance of tribal communities have fostered a well-earned sense of political power and self-reliance. Though there once were millions of aboriginal inhabitants on the land that now constitutes the United States, today the American Indian and Alaska Native populations have been reduced to less than 2.5 million. We, as a community of Americans, cannot afford to lose more lives or cultural riches from American Indian and Alaska Native cultures. HIV/AIDS is a significant threat to these communities that we must address.

We are faced with a growing HIV/AIDS epidemic in communities that often goes unreported. HIV infection case data reported in 33 states indicate that American Indians and Alaska Native comprise .6% of all new HIV infections when they only represent .7% of the U.S. population. This statistic represents an alarming reality for the future of American Indian and Alaska Native communities. We must work together to prevent the further spread of HIV/AIDS in these communities that are already tremendous risk due to undercounting, under-reporting and the high risk mix of other sexual transmitted diseases (STDs), drug use and alcoholism. American Indians and Alaska Natives are facing a health crisis that will continue to grow disproportionately unless these communities take action.

We, in the federal government, hear, understand and clearly recognize the total impact of HIV in the community. In order to respond to the concern about undercounting and under-reporting of the epidemic, the Indian Health Service (IHS) and the Centers for Disease Control (CDC) have been working with community-based organizations to improve prevention and surveillance. It is vital that we all work together. We need people to challenge the community by working with groups that have already walked the path and with community members who have taken the steps in addressing the rising epidemic.

Many tribal nations and local community-based organizations are working to prevent HIV/AIDS, and are providing care to those living with the disease. There are many examples of effective outreach to help guide the way. The First Annual Southeastern Regional Native American HIV/AIDS, STD, Drug and Alcohol Abuse Conference, Changing Winds: A Vision of Hope, hosted by the Catawba Indian Nation and other groups, is evidence of exciting and encouraging work within the American Indian and Alaska Native communities. The first ever Tribal conference east of the Mississippi on HIV/AIDS brought together leadership from 21 tribes to promote unity, ease stigmas, provide skills and foster motivation within tribal communities while arming participants with knowledge, spiritual support and compassion. For information about this conference and/or the Catawaba Indian Nation, call (803) 366-4792.

The National Native American AIDS Prevention Center (NNAAPC) offers HIV case management services through the Native Care Network, a collaborative effort between NNAAPC, the Ahalaya Native Care Project, Inc., and six Native American organizations. In addition, NNAAPC provides capacity-building assistance to support HIV prevention projects. Visit this organization online at http:www.nnaaapc.org, or by phone at (510) 444-2051. The Ogitchidag Gikinooamaagad Players, an education program of the Minnesota American Indian AIDS Task Force (email: MAIAT@aol.com) is a group of young Native actors dedicated to HIV/AIDS education through story telling, drama, and dance. In Colorado, Only One (wenakuo@juno.com, or phone (303) 939-9201) provides training to spiritual elders to enhance community efforts to fight HIV/AIDS. These organizations, along with the National AIDS Hotline (1-800-342-AIDS) are anxious to assist you. I encourage you to contact them.

As we endeavor to better track the path of HIV/AIDS in American Indian and Alaska Native communities, the stakes continue to rise and HIV/AIDS continues to take its deadly toll. I must agree with a Changing Winds participant: “With few numbers, the threat the HIV poses to the Native American community is incalculable. It is imperative that we intercede before HIV wreaks upon our community the same devastation that we witnessed with small pox and TB. Only a concerted effort on all parts will assure our survival.” These powerful words speak a powerful truth. We have an opportunity to prevent the disproportionate impact of HIV/AIDS due to the coalescing factors of undercounting and high-risk behaviors. Let us together educate, motivate and mobilize against HIV/AIDS.

By Dr. David Satcher

Assistant Secretary for Health and U.S. Surgeon General

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