ANCHORAGE - HIV/AIDS is a silent killer moving through Native communities around the world, says Rick Haverkate.
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"It is not being talked about until it is too late," said Haverkate, an American Indian who hopes to change that with a conference on HIV/AIDS among Natives in the United States and Canada.
More than 800 people are expected to attend "Embracing Our Traditions, Values and Teachings: Native Peoples of North America HIV/AIDS Conference" in Anchorage from May 2-6.
The conference aims to provide Native people with information on HIV/AIDS research, while establishing networks to tackle the problem that organizers say disproportionately affects about 2.6 million Natives in the United States.
The Centers for Disease Control and Prevention says American Indians and Alaska Natives account for less than 1 percent of new HIV diagnoses in the United States. Overall, American Indians and Alaska Natives in 2004 had a diagnoses rate of 11.1 per every 100,000 people. That compares to a rate of 76.3 among blacks and 29.5 among Hispanics. Whites were 9 per 100,000.
While the numbers for American Indians and Alaska Natives aren't impressive at first glance, conference organizers say it is important to remember that the disease is affecting some very small communities.
To make matters worse, the number of American Indians with HIV is being underreported, said Michael Covone, program manager for the HIV prevention program with the Alaska Native Tribal Health Consortium, who will conduct a couple of conference workshops.
For more on HIV/AIDS among natives, check out www.embracingourtraditions.org
"A lot of American Indians have been classified as Hispanic," he said. "We are missing a whole bunch of people."
That means that the problem has not received the attention it deserves when it comes to federal funding for prevention and treatment models, Covone said.
"Communities that are most affected receive the most funds," Covone said. "Alaska Native and American Indians have not been a focus for prevention ... . Nothing has been done to meet the needs of that community in particular."
Conference participants include American Indians and Alaska Natives from more than 600 sovereign nations, as well as physicians, nurses, pharmacists, researchers, elders and spiritual leaders from more than 40 states, Canada and New Zealand.
Nearly 80 presenters will give lectures and workshops, with more intimate talking circles available for people with specific common interests. Conference participants can even visit a sweat lodge while in Anchorage if they wish, Haverkate said.
"We really want to foster spiritual and cultural grounding," he said.
Lecture topics are numerous and include Understanding the Trends in HIV/AIDS Among Native Peoples, Adapting New Treatments to Native Settings, Special Populations and Stigma, Risky Behaviors and Defining Native Identity.
Many times Alaska Natives don't find out they are HIV-positive until they have AIDS, perhaps dying just a few months later, Covone said.
The problems can be as basic as how to test for HIV in the villages, he said.
"How do you get a nurse to do the testing without everyone knowing it?" Covone asked.
On top of that is the lingering stigma of being Native and a feeling of being cut off from the rest of the world, Covone said.
"There are layers and layers of issues and HIV just becomes another one of them," he said.
Even without the stigma of being HIV positive or having AIDS, it can be particularly tough to be gay and American Indian or Alaska Native, said Haverkate, who is a member of the Sault Ste. Marie tribe and director of the health services for the Inter-Tribal Council of Michigan, Inc.
"It is a very scary issue. A lot of our Native youth who are gay or lesbian leave the reservation. They don't feel like there is a place for them."
Tommy Chesbro, one of the conference's keynote speakers, said traditionally Native populations have been more accepting of homosexuality, but that has been increasingly lost with Natives being assimilated into white society.
"Some Native peoples have lost those traditional values relating to that specific issue," he said.
Chesbro points to a tradition in Native cultures of the "two-spirited individual," a person with both masculine and feminine aspects.
"In many tribes there were roles in their societies for those gay and lesbian individuals," he said. "Oftentimes those individuals, because they could walk in both roles, would be mediators in the tribes between the men and the women."
Chesbro said it is important to remember that AIDS has gone far beyond being a gay problem. The HIV infection rate among American Indian and Alaska Native women at 7.7 per 100,000 is more than twice the rate of white women, according to the CDC. The rate for American Indian and Alaska Native men at 20.8 per 100,000, was slightly higher than the rate for white men.
The factors at play for HIV transmission in American Indian and Alaska Native communities are the same as elsewhere, and have more to do with drug and alcohol use and having unprotected sex, said Chesbro, who is vice president of education for Planned Parenthood of Arkansas and eastern Oklahoma.
Chesbro, who is gay and HIV-positive for almost 21 years, said American Indians and Alaska Natives have to do a better job of working together as one people on the problem.
"When you have a group that has been marginalized and their voice taken away, as in a way we have, sometimes it can be hard to find that voice again. This is something we really need to find that common voice on," he said.