1. Female: The Primary Gender in Navajo August 14, 2004 2004 Minority Womens Health Summit Washington, DC Yvonne M. Davis, MPH

2. Goals of this presentation To explore current epidemiology affecting AI/AN/NH women. To explore current HIV and AIDS prevention strategies that work. To identify best practices that include prevention, diagnosis and treatment of HIV/AIDS disease. To identify processes to dialog with indigenous leaders to address current HIV/AIDS health issues for indigenous women. To recommend action-oriented strategies to increase positive health outcomes for AI/AN/NH women.

3. CDC (2002); U.S. Census Bureau (2000); Bertolli (2004) Current Epidemiology of HIV/AIDS for AI/AN. We make up 0.7% of the U.S. population. AI/AN represents 0.3% of reported AIDS cases and 0.6% of reported HIV cases. Cumulative total of 3,499 HIV/AIDS cases. 2,537 have been diagnosed with AIDS. – 21% are female – 1.3% are younger than 13 years of age

4. Bertolli et al. (2004) Current Epidemiology in AI/AN women – affecting HIV/AIDS rates In 2001, 172 AI/AN persons were reported as HIV positive. 21% of reported HIV cases were AI/AN female. In 2001 the percentage of exposure for HAR to IDU were equal. Suicide rates among AI/AN/NH youth are 8.9, 20.1, and 31.3.

5. Alaska Department of Health and Social Services (2002). Current Epidemiology for AI/AN women: Alcohol Alaska Native has the highest rate of FAS/FAE -- 1.4/1,000 babies. Illegal substance abuse rate for AN youth: – 44% Alcohol – 29% use marijuana – 19% use inhalants

6. Risks identified; needs documentation Decreasing access to education and employment and increasing poverty among AI/AN/NH women. Increasing AI/AN/NH womens social and economic dependency on men Reducing womens power and choice in their relationships and in other aspects of their lives. Reducing the invisibility of AI/AN/NH women in HIV/AIDS research.

7. Duran, E., & Duran, B., Yellowhorse, M, & Yellowhorse, S. (1998) Empowering AI/AN/NH women Prevent the social conditions affecting AI/AN/NH women. Specifically hone interventions to fit into cultural domains of each tribe. Support the upholding of the Matrilineal/Patrilineal hierarchy among AI/AN/NH communities. Prevent societal barriers such as: – Sexism, racism, and colonialism.

8. Exploring effective interventions for AI/AN women. In Native communities, who are the women impressing? In Native communities, how is beauty defined? Values that are not indigenous are defining how Empowerment is defined in Native Communities.

9. Laverack G., Wallerstein, N. (2001); Man % Van Winkle, (1994) Solutions More education in any way and in any form. Educate to get current health information issues out. Decrease the paradox of community-base participation research at the tribal level. To look like the Native women, one would listen to another who looks like themselves.

10. Conclusion Funding for education must increase. Funding should not only target youth. Education is not a one-stop workshop. Education cannot be narrowly and individually targeted. Education needs to be age/language/gender/and culturally appropriate.