New Mexico Tribe Confronts HIV: Infections Are Rising in Navajo Nation, Where Poor Education Is Partly to Blame for the Virus' Spread

The Indian Medical Center (IMC) in Gallup, N.M., has become an epicenter in the struggle against rising HIV infections among Native Americans, mostly Navajo. In the vast expanse of the Four Corners region, poverty, poor education, alcohol and drug abuse form a high-risk environment for those living on the reservation.

The number of infections in the 173,600-person Navajo Nation is low: IMC and its satellite clinics log about 35 new cases a year. But that figure is three times what it was 10 years ago. Dr. Jonathan Iralu, infectious-disease specialist at IMC, said he began seeing signs of trouble in 2001, when testing indicated Navajo were infecting Navajo. Up until that point, HIV was rare on the reservation and usually seen in infected gay or bisexual men who returned home for treatment or to die, he said.

Larry Foster, the reservation's STD coordinator, said health providers encounter resistance when talking to residents about the disease because in traditional Navajo culture to speak of death is to bring it about. "They didn't want to listen because they thought we were bringing a curse, bringing death into their communities," he said. Doctors must explain the virus in indirect ways, a serious prevention hurdle. Some Navajos learn about HIV/AIDS only upon receiving a diagnosis.

A small number of Indians are trying to warn Navajos about HIV/AIDS. Emerson Scott and Jerry Archuleta, partners who are both HIV-positive, volunteer with the Navajo AIDS Network, handing out condoms and pamphlets and urging people to get tested. So far, not one person has done so. "People just don't want to change here," said Archuleta. "They are so stuck in their ways."

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