With an estimated 18 percent of HIV-positive Native Americans and Alaska Natives unaware of their status, Indian Health Service is among the agencies specifically tasked with helping stop the virus’ transmission.
As part of the 2019 State of the Union address, President Donald Trump announced an initiative to reduce the number of HIV cases by 75 percent within five years and 90 percent within a decade.
A citizen of the Sault Ste. Marie Tribe of Chippewa Indians, Rick Haverkate is IHS’ National HIV/AIDS & Hepatitis C program coordinator.
Under the auspices of the initiative, IHS is working with tribal epidemiology centers in each of its regions to determine how to best address HIV testing and prevention efforts. A pilot program is also underway with the Cherokee Nation Health Services. Plans are also in the works for consultation sessions through the National Indian Health Board and the National Council on Urban Indian Health.
“We look at it as targeted community-specific plans,” Haverkate said. “It’s not just a national voice speaking from D.C. We’re trying to get funds into the local communities and meet their specific needs.”
Although it is too early to determine what impact the initiative has had on the transmission rates in Indian Country, Haverkate noted that IHS has been working with urban clinics and tribally operated facilities for years to promote testing and access to care for HIV and AIDS patients.
“More than half of the patients coming into IHS clinics have had at least one HIV test,” he said. “We are also making efforts to screen all pregnant moms.”
In the interim, efforts are underway to facilitate access to preventative services.
Sponsored by the Department of Health and Human Services, another partner organization in the elimination efforts, the Ready Set PrEP Program provides free pre-exposure prophylaxis medication to people who do not have prescription drug coverage but are considered at risk to contract HIV or AIDS.
If taken daily, PrEP medication alone can reduce the risk of contracting HIV through sexual contact by up to 90 percent. Among intravenous drug users, PrEP medication reduces the transmission risk by 70 percent. It is part of the standard formulary at IHS pharmacies.
Additionally, the first day of spring, March 20, has been observed as National Native HIV/AIDS Awareness Day since 2007. Overseen by the National Native HIV Network, this year’s theme was “Resilience + Action: Ending the Epidemic for Our Native Communities.”
According to the Centers for Disease Control and Prevention’s 2017 HIV Surveillance Report, the diagnosis rate for HIV is higher among both Indigenous men and women than their white neighbors. For every 100,000 people, 17.4 American Indian/Alaska Native men and 4.5 American Indian/Alaska Native women are diagnosed with HIV, compared to 10.2 white men and 1.7 white women.
Between 2012 and 2016, the number of new HIV diagnoses across Indian Country increased by 34 percent with the highest spike among gay and bisexual Indigenous men. The higher rate of diagnoses coincides with a 63 percent increase in screening among Natives ages 13 to 64.
HIV transmission happens when infected blood or bodily fluids containing blood cells enter the body. Infection cannot occur through normal or casual contact, such as hugging, kissing, dancing or shaking hands with someone who has HIV or AIDS. Additionally, HIV cannot be spread through insect bites, air or water.
An estimated 38,000 people are infected annually in the United States with 9 out of 10 HIV infections transmitted by people who are not diagnosed or in care. Despite not being identified until 1984, the virus has killed more than 35 million people with an estimated 1 million annual casualties.
The longer gap between contracting the virus and getting a diagnosis provides more opportunities for HIV to destroy a person’s immune system and an increase risk of developing AIDS. However, early diagnosis and a regular course of antiretroviral medication can suppress the virus’ growth in a person’s blood to the point it is not transmittable in as little as six months.
HIV testing is available at both of the Citizen Potawatomi Nation’s clinics to Tribal citizens, employees and area residents who are enrolled with a federally recognized tribe. It is also available for free through the Pottawatomie County Health Department.
“We are just a humble partner,” Haverkate said. “We’re just lucky to be a partner with a national reach.”