While infection rates of the human immunodeficiency virus (HIV) are holding steady or declining nationwide, the number of HIV-positive diagnoses on the Navajo reservation is rising. The Los Angeles Times reports that issues such as poverty, poor education, alcohol abuse and other hardships in the Four Corners region, home to the Diné people, foster an environment in which HIV can easily spread.
Poor education is one of the main culprits. Some tribal members do not learn about the diseases until they’re diagnosed. For instance, Diné member Elsie Smith lost her husband to AIDS. Soon after his passing, she became physically ill. Her bones ached and she vomited regularly. Hospital ridden, her doctor recommended she take an HIV-test, which returned positive. Her first question to the doctor was, “What is HIV?”
For doctors, explaining the disease requires sensitivity and careful wording, because in traditional Navajo culture, to speak of death is to invite it.
According to Larry Foster, the Navajo Nation’s sexually transmitted disease coordinator, the response to presentations on HIV and AIDS has been adverse. “They didn’t want to listen because they thought we were bringing a curse, bringing death into their communities,” Foster told the Los Angeles Times. “Nobody cares until they have seen an AIDS death in their family.”
Other obstacles include access to health and social services, which is often restricted by distance to facilities, poverty and unemployment, and inadequate health-care funding, according to a public health report by the Association of Schools of Public Health that assessed risk factors for the progression of HIV among American Indians.
But early diagnosis is vital so treatment can begin to help prevent HIV from advancing to AIDS.
One medical center in the Four Corners region is working to reduce HIV transmissions among Navajos and offers culturally competent treatment and care. At the Indian Medical Center in Gallup, New Mexico, modern medicine meets traditional Navajo healing. Medicine men visit hospital rooms to offer ancient prayers, blessings and healing herbs for drinking. Dual treatment is encouraged by the Indian Health Service so patients feel more optimistic about their treatment and continue receiving care.