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Universal HIV Screening: Putting Policy into Practice in Hard-to-Reach Populations: American Indians/Alaska Natives (AI/AN). IOM Workshop HIV Access and Testing April 15, 2010 RADM Scott Giberson, RPh, PhC, M.P.H. IHS National HIV/AIDS Program Rockville, MD. AI/AN HIV Epidemiology*.
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HIV Access and Testing
April 15, 2010
RADM Scott Giberson, RPh, PhC, M.P.H.
IHS National HIV/AIDS Program
Incidence rates, 2007: AI-AN = 14.6/100K (Rank 3rd )
Est. # living with HIV/AIDS roughly 3,500+.
Rate of HIV Dx for AI/AN men (17.7per 100K) and for females roughly 4.6/100K.
Similar time from HIV to AIDS of all races/ethnicities
Shortest time (with African American) from AIDS diagnosis to death. *
Most MSM/IDU combo of any ethnicity *
AI/AN youth at higher risk (YBRS, BIA/CDC 2002)
* CDC HIV/AIDS Surveillance Report 2006, Released Feb 2009:
* 33-state HIV/AIDSSurveillance Data through 2006; 34-states in 2007
Assist AI/A N individuals in becoming aware of HIV serostatus - Support CDC revised HIV testing recommendations.
Decrease risk through education, open communication, and the reduction of stigma
Ensure access to quality health services, including people living with HIV/AIDS
Form sustainable collaborations with Tribes, community stakeholders, states, federal agencies and other HIV partners
Be transparent, culturally fluent and accountable
Research / Epidemiology
Integrate Intervention Model into Priority Areas
Broad sociocultural / traditionalism/ spiritual
Clinical / Facility
Impact: Prenatal HIV Screening
Source: GPRA Data 2005-2009
Data from latest ‘patch’ into our operating RPMS system. Aggregate, non-identifiable numbers:
Number of HIV screens performed:GRPA YearNumber
Conclusions: Majority of IHS physicians and nurses support the 2006 Revised CDC HIV Testing guidelines. Providers need more information and training on HIV Testing guidelines, implementation strategies, and state HIV regulations.
77% worked with AETC
62% changed HIV policy in writing
69% bundle HIV as STD panel
Wide range of costs for tests ($5-$75)
Long range to referral sites (Average distance over 100 miles with minimum near 50 miles)
To date, anecdotal and objective data indicate: